ANTELOPE VALLEY NEPHROLOGY MEDICAL GROUP, INC.
NPI 1336172949
Specialist in Lancaster, CA

Q: What is Antelope Valley Nephrology Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since July 08, 2006CLIA 05D0587928 · Waiver

1759 W AVENUE J # 101, LANCASTER, CA 93534(661) 948-1388(661) 948-1223 Get Directions Write a Review

NPPES record last updated: February 23, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Antelope Valley Nephrology Medical Group, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANTELOPE VALLEY NEPHROLOGY MEDICAL GROUP, INC. (NPI 1336172949) is a healthcare organization registered as a specialist in Lancaster, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through December 31, 2027 and lists Sung C Yang, Administrator, as its authorized official.

NPPES Registry Identity

NPI1336172949

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameANTELOPE VALLEY NEPHROLOGY MEDICAL GROUP, INC.

Location Address1759 W AVENUE J # 101Lancaster, CA 93534-2703

Mailing AddressPo Box 2768Lancaster, CA 93539-2768 · (661) 948-8309 · Fax (661) 948-8907

Phone(661) 948-1388

Fax(661) 948-1223

Organization SubpartNo

Authorized OfficialSung C YangAdministrator · (661) 948-1388

Enumeration DateJuly 8, 2006

Last NPPES UpdateFebruary 23, 2016

✔ NPI 1336172949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

1759 W AVENUE J # 101, Lancaster, CA 93534

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Other Identifiers 4

MedicaidGR0002830CA

Medicare PINW6508CA

Medicare PINZZZ15456ZCA

Other954053663CA · Tax Id

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0587928

Antelope Valley Nephrology Medical Group · Lancaster, CA

Active · expires Dec 31, 2027

CLIA Number05D0587928

Laboratory TypePhysician Office

Certificate Effective DateJanuary 1, 2026

Certificate Expiration DateDecember 31, 2027

Laboratory DirectorBassel Hadaya

Laboratory Phone(661) 948-3203

Laboratory LocationAntelope Valley Nephrology Medical Group1759 W Ave J, Ste 101, Lancaster, CA 93534

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Antelope Valley Nephrology Medical Group, Inc.'s NPI number?

The NPI number for Antelope Valley Nephrology Medical Group, Inc. is 1336172949. It was assigned to this organization in the NPPES registry on July 8, 2006.

Where is Antelope Valley Nephrology Medical Group, Inc. located?

Antelope Valley Nephrology Medical Group, Inc. is located at 1759 W Avenue J # 101, Lancaster, CA 93534. The listed phone number is (661) 948-1388.

What is Antelope Valley Nephrology Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Antelope Valley Nephrology Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0587928) is associated with this NPI, valid through December 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Antelope Valley Nephrology Medical Group, Inc. was last updated on February 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.