NPIMap

Adventist Health Heart Institute-Ukiah

Organization Active NPI Multi-Specialty Clinic/Center · Ukiah, CA

NPI 1417295643 · NPPES record last updated Jan 9, 2018

Key facts

NPI
1417295643
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
ADVENTIST HEALTH HEART INSTITUTE-UKIAH
Practice address
115 Hospital Dr
Ukiah, CA 95482-4591
Phone
(707) 463-2400
Fax
(707) 463-3520
NPI assigned
Jan 23, 2013
Organization subpart
No

Authorized official

Name
Adrian Serna
Title
Cfo
Phone
(916) 865-1865

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 282

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

View all 282

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050407000633 CA Part B Supplier - Clinic/Group Practice 3274580972 Receives reassigned benefits from 808 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Clafiornia Med FD (166 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

115 Hospital Dr
Ukiah, CA 95482-4591

Mailing address

PO Box 398794
San Francisco, CA 94139-8794

Other providers in Ukiah, CA

All providers in Ukiah, CA · Multi-Specialty Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.