RCOA-ADVENTIST HEALTH LLC NPI 1104872910

NPI Information

NPI: 1104872910
Provider Name: RCOA-ADVENTIST HEALTH, LLC
Classification: Clinic/Center - 261QR0208X
Specialization: Radiology, Mobile
Entity Type: Organization
Doing Business As: ADVENTIST HEALTH PET/CT - UKIAH
CLIA Number: 05D2295148
Address: 275 HOSPITAL DR
UKIAH, CA
ZIP 95482
Phone: (866) 293-3500

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NPI Details

RCOA-ADVENTIST HEALTH, LLC is a radiology and mobile clinic center in Ukiah, CA. RCOA-ADVENTIST HEALTH, LLC NPI is 1104872910. The provider is registered as an organization entity type.
The provider Is Doing Business As Adventist Health Pet/ct - Ukiah.

The provider's business location address is:

275 HOSPITAL DR
UKIAH, CA
ZIP 95482-531
Phone: (866) 293-3500
Fax: (866) 293-3535

The provider's authorized official is Allen Mcgee .
The authorized official title is Chairman & Ceo and has the following contact phone number (561) 477-3500.

The CLIA number assigned to this NPI record is 05D2295148 - other - hboc with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 8/13/2008.

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	261QR0208X	Clinic/Center	Radiology, Mobile	6838-17	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	ZZZ66594Z	OTHER	CALIFORNIA	BS OF CA PROVIDER NUMBER
2	ZZZ31885Z	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	PROVIDER NUMBER

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: 11/21/2025

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