Healthcare Provider Details

I. General information

NPI: 1902109580
Provider Name (Legal Business Name): PLANNED PARENTHOOD ANTELOPE VALLEY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2010
Last Update Date: 07/10/2021
Certification Date: 07/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 E PALMDALE BVLD SUITE 533 A1
PALMDALE CA
93550-2375
US

IV. Provider business mailing address

400 W 30TH ST
LOS ANGELES CA
90007-3320
US

V. Phone/Fax

Practice location:
  • Phone: 213-284-3129
  • Fax: 661-266-3216
Mailing address:
  • Phone: 213-284-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDA PAHL
Title or Position: CFO
Credential:
Phone: 213-284-3210