ADVENTIST HEALTH CLEARLAKE HOSPITAL INC-MIDDLETOWN FAMILY HEALTH CENT NPI 1124204821

NPI Information

NPI: 1124204821
Provider Name: ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC-MIDDLETOWN FAMILY HEALTH CENT
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
18TH AVE AND HIGHWAY 53
CLEARLAKE, CA
ZIP 95422
Phone: (707) 987-3311
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ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC-MIDDLETOWN FAMILY HEALTH CENT is a rural health clinic center in Clearlake, CA. ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC-MIDDLETOWN FAMILY HEALTH CENT NPI is 1124204821. The provider is registered as an organization entity type.

The provider's business location address is:

18TH AVE AND HIGHWAY 53
CLEARLAKE, CA
ZIP 95422-710
Phone: (707) 987-3311
Fax: (707) 987-2455

The provider's authorized official is Jennifer L. Swenson .
The authorized official title is Chief Financial Officer and has the following contact phone number (707) 995-5811.

The enumeration date for this NPI number is 1/14/2008 and was last updated on 1/20/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	110000174	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BCP08586F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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