Organization Active NPI

Antelope Valley Lung Institute Medical Group

  • Specialist
  • Lancaster, CA
National Provider Identifier
1760682140
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ANTELOPE VALLEY LUNG INSTITUTE MEDICAL GROUP
Practice address
1331 W Avenue J
Suite 101
Lancaster, CA 93534-2942
Phone
(661) 945-8717
Fax
(661) 945-4867
NPI assigned
Jul 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Pradeep Balkrishna Damle, MD
Title
Partner
Phone
(661) 945-8717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1331 W Avenue J
Suite 101
Lancaster, CA 93534-2942

Mailing address

1331 W Avenue J
Suite 101
Lancaster, CA 93534-2942
Phone (661) 945-8717

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206057600000",
    "number": "1760682140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 W AVENUE J",
            "address_2": "SUITE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342942",
            "telephone_number": "661-945-8717",
            "fax_number": "661-945-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 W AVENUE J",
            "address_2": "SUITE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342942",
            "telephone_number": "661-945-8717",
            "fax_number": "661-945-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTELOPE VALLEY LUNG INSTITUTE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2008-03-21",
        "status": "A",
        "authorized_official_last_name": "DAMLE",
        "authorized_official_first_name": "PRADEEP",
        "authorized_official_middle_name": "BALKRISHNA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "661-945-8717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.