ADVENTIST HEALTH MENDOCINO COAST NPI 1124220249

NPI Information

  • NPI: 1124220249
  • Provider Name: ADVENTIST HEALTH MENDOCINO COAST
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Doing Business As: MENDOCINO COAST DISTRICT HOSPITAL
  • CLIA Number: 05D0611996
  • Address: 721 RIVER DRIVE
    SUITE A
    FORT BRAGG, CA
    ZIP 95437
  • Phone: (707) 961-4631

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NPI Details

ADVENTIST HEALTH MENDOCINO COAST is a rural health clinic center in Fort Bragg, CA. ADVENTIST HEALTH MENDOCINO COAST NPI is 1124220249. The provider is registered as an organization entity type.
The provider Is Doing Business As Mendocino Coast District Hospital.

The provider's business location address is:

721 RIVER DRIVE
SUITE A
FORT BRAGG, CA
ZIP 95437
Phone: (707) 961-4631
Fax: (707) 964-1192

The provider's authorized official is Judson Howe .
The authorized official title is President and has the following contact phone number (707) 456-3010.

The CLIA number assigned to this NPI record is 05D0611996 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2007 and was last updated on 7/8/2022.

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
1261QR1300XClinic/CenterRural HealthYes

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: 3/30/2025

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