Unknown Individual – Family Medicine Physician, NPI 1104838648
Family Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
39115 TRADE CENTER DR STE 130
PALMDALE, CA 935513649
Phone: (661) 273-0100
Fax: (661) 273-5812
Type: Location
44469 10TH ST W
LANCASTER, CA 935343324
Phone: (661) 945-9411
Fax: (661) 945-8191
Type: Mailing
38636 MEDICAL CENTER DR STE C
PALMDALE, CA 935514689
Phone: (661) 273-0100
Fax: (661) 273-5812
Type: Location
39115, Trade Center Drive, Palmdale, Los Angeles County, California, 93551, United States
PALMDALE, CA 935513649
Phone: (661) 273-0100
Fax: (661) 480-2088
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 93551)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CA | |
| Nurse Practitioner | CA | |
| Family Practice | CA | |
| Internal Medicine | CA | |
| Family Practice | CA | |
| Family Practice | CA | |
| General Practice | CA | |
| - | CA | |
| - | CA | |
| - | CA |
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