National Provider Identifier Database

ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP INC
Cardiovascular Disease

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.


Contact Information

ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
15322 LAKESHORE DR
SUITE 203
CLEARLAKE, CA95422-9814
Phone: 707-968-2809
Fax: 707-963-9185
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X
Urology 208800000X

* Indicates primary specialty

NPI Profile & details for ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.

NPI Number 1154646982
Legal business name
LBN
ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Authorized official KAYE DONNELLY - (CREDENTIALING COORDINATOR)
Entity Organization
Organization subpart No
Enumeration date 04/05/2010
Last updated 04/05/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: A106559
  • CA License #: C32535

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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