Antelope Valley Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A667882 Issued in CA

Legal business name

ANTELOPE VALLEY MEDICAL GROUP

Practice address

357 E Balfour Ave
Fresno, CA 93720-0709

Phone

(559) 434-0203

NPI assigned

Jun 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Kain Kumar

Title

President

Phone

(661) 618-8119

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1790198299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 W PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 E BALFOUR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200709",
            "telephone_number": "559-434-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTELOPE VALLEY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "KAIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-618-8119",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A667882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.