NPIMap

Organization Active NPI

Adventist Health California Medical Group, Inc.

  • Internal Medicine Physician
  • Hidden Valley Lake, CA
National Provider Identifier
1699054650
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Practice address
18990 Coyote Valley Rd
Suite 5
Hidden Valley Lake, CA 95467-8337
Phone
(707) 987-9024
Fax
(707) 987-9152
NPI assigned
Aug 9, 2011
Last updated
Aug 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Authorized official

Name
Kaye A Donnelly
Title
Specialist, Contract Compliance
Phone
(707) 968-2809

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Cardiovascular Disease Physician 207RC0000X
Hematology & Oncology Physician 207RH0003X
Surgery Physician 208600000X
Urology Physician 208800000X

Addresses

Primary practice location

18990 Coyote Valley Rd
Suite 5
Hidden Valley Lake, CA 95467-8337

Mailing address

1001 Adams St
Suite 102
Saint Helena, CA 94574-1107
Phone (707) 968-2809

National Provider Directory

National Provider Directory
Tax ID family
Adventist Health California Medical Group Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1699054650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ADAMS ST",
            "address_2": "SUITE 102",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945741107",
            "telephone_number": "707-968-2809",
            "fax_number": "707-963-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18990 COYOTE VALLEY RD",
            "address_2": "SUITE 5",
            "city": "HIDDEN VALLEY LAKE",
            "state": "CA",
            "postal_code": "954678337",
            "telephone_number": "707-987-9024",
            "fax_number": "707-987-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "KAYE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SPECIALIST, CONTRACT COMPLIANCE",
        "authorized_official_telephone_number": "707-968-2809"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hidden Valley Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.