ADVENTIST HEALTH CLEARLAKE HOSPITAL INC NPI 1477104099

NPI Information

NPI: 1477104099
Provider Name: ADVENTIST HEALTH CLEARLAKE HOSPITAL INC

Doing Business As: ADVENTIST HEALTH CLEAR LAKE

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
15322 LAKESHORE DRIVE
SUITE 101, 102 AND 201
CLEARLAKE, CA
ZIP 95422
Phone: (707) 461-7986
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ADVENTIST HEALTH CLEARLAKE HOSPITAL INC is a rural health clinic center in Clearlake, CA. ADVENTIST HEALTH CLEARLAKE HOSPITAL INC NPI is 1477104099. The provider is registered as an organization entity type.
The provider Is Doing Business As Adventist Health Clear Lake.

The provider's business location address is:

15322 LAKESHORE DRIVE
SUITE 101, 102 AND 201
CLEARLAKE, CA
ZIP 95422
Phone: (707) 461-7986

The provider's authorized official is Colleen Assavapisitkul .
The authorized official title is President and has the following contact phone number (707) 995-5827.

The enumeration date for this NPI number is 9/25/2019 and was last updated on 12/20/2022.

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			Yes

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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