Adventist Health California Medical Group, Inc.
Organization Active NPI Cardiovascular Disease Physician · Clearlake, CA
NPI 1831486653 · NPPES record last updated Jun 30, 2011
Key facts
- NPI
- 1831486653
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
- Practice address
- 15250 Lakeshore Dr
Suite C
Clearlake, CA 95422-8107 - Phone
- (707) 995-3764
- Fax
- (707) 995-0904
- NPI assigned
- Jun 30, 2011
- Organization subpart
- No
Authorized official
- Name
- Kaye A. Donnelly
- Title
- Specialist, Contract Compliance
- Phone
- (707) 968-2809
Corporate family (same tax ID) 34
National Provider Directory
- Tax ID family
- Adventist Health California Medical Group Inc
Locations
1001 Adams St
Ste 102
Saint Helena, CA 94574
Phone (707) 968-2809
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes |
Addresses
Primary practice location
15250 Lakeshore Dr
Suite C
Clearlake, CA 95422-8107
Mailing address
1001 Adams St
Suite 102
Saint Helena, CA 94574-1107
Phone (707) 968-2809
Other providers in Clearlake, CA
- Adventist Health California Medical Group, Inc.
- Adventist Health California Medical Group, Inc.
- Adventist Health California Medical Group, Inc.
- Adventist Health California Medical Group, Inc.
- Adventist Health California Medical Group, Inc.
- Adventist Health Clearlake Hospital Inc
- Adventist Health Clearlake Hospital Inc.
- Adventist Health Clearlake Hospital Inc.
- Adventist Health Clearlake Hospital Inc.
- Adventist Health Physician Network
All providers in Clearlake, CA · Cardiovascular Disease Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.