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General NPI Number Information
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NPI Number | 1225054257
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Entity Type | Organization
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Legal Business Name | ANTELOPE VALLEY EMERGENCY MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 1600 W AVENUE J
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City | LANCASTER
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State | CA
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Zip | 93534-2814
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Country | US
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Telephone | 661-254-4707
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 740530
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City | LOS ANGELES
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State | CA
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Zip | 90074-0530
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Country | US
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Telephone | 855-691-9890
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW G. RICHARD
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Credential | M.D.
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Telephone | 310-346-1071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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