NPIMap

Organization Active NPI

Rcoa-Adventist Health, LLC

Doing business as Adventist Health PET/CT - Redbud

  • Mobile Radiology Clinic/Center
  • Clearlake, CA
National Provider Identifier
1649223900
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
License
6838-17 Issued in CA
Legal business name
RCOA-ADVENTIST HEALTH, LLC
Doing business as
Adventist Health PET/CT - Redbud
Practice address
18TH Avenue at Highway 53
Clearlake, CA 95422
Phone
(866) 293-3500
Fax
(866) 293-3535
NPI assigned
May 18, 2006
Last updated
Aug 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Mr. Allen McGee
Title
Chairman & Ceo
Phone
(561) 477-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X 6838-17 CA Primary

Addresses

Primary practice location

18TH Avenue at Highway 53
Clearlake, CA 95422

Mailing address

P. O . Box 850001
Orlando, FL 32885-0120
Phone (866) 293-3500

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ66595ZOtherCAPROVIDER NUMBER

Other names 1

  • Adventist Health PET/CT - Redbud Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Adventish Health Pet CT Kaweah Delta6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1649223900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O . BOX 850001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850120",
            "telephone_number": "866-293-3500",
            "fax_number": "866-293-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18TH AVENUE AT HIGHWAY 53",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "95422",
            "telephone_number": "866-293-3500",
            "fax_number": "866-293-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RCOA-ADVENTIST HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "CHAIRMAN & CEO",
        "authorized_official_telephone_number": "561-477-3500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "CA",
            "license": "6838-17",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "ZZZ66595Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health PET/CT - Redbud",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clearlake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.