| Adventist Health Clearlake Hospital, Inc-kelseyville Family Health Cen | |
|
18th Ave And Highway 53 Clearlake CA 95422-6710 | |
| (707) 279-8813 | |
| (707) 279-2241 |
| Full Name | Adventist Health Clearlake Hospital, Inc-kelseyville Family Health Cen |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 18th Ave And Highway 53, Clearlake, California |
| Authorized Official Name and Position | Jennifer L. Swenson (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7079955811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adventist Health Clearlake Hospital, Inc-kelseyville Family Health Cen Po Box 6710 Clearlake CA 95422-6710 Ph: (707) 994-6486 | Adventist Health Clearlake Hospital, Inc-kelseyville Family Health Cen 18th Ave And Highway 53 Clearlake CA 95422-6710 Ph: (707) 279-8813 |
| NPI Number | 1942486642 |
|---|---|
| Provider Enumeration Date | 01/14/2008 |
| Last Update Date | 01/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942486642 | NPI | - | NPPES |
| BCP19999G | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 110000174 (California) | Primary |
St. Helena Family Practice Clearlake Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15322 Lakeshore Dr, Suite 202, Clearlake, CA 95422 Phone: 707-994-0305 | |
Lake County Tribal Health Southshore Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14440 Olympic Drive, Clearlake, CA 95422 Phone: 707-263-8382 Fax: 707-263-5019 | |
Adventist Health Clearlake Hospital, Inc-middletown Family Health Cent Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18th Ave And Highway 53, Clearlake, CA 95422 Phone: 707-987-3311 Fax: 707-987-2455 | |
Family Care Partners Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15322 Lakeshore Dr, Ste. 201, Clearlake, CA 95422 Phone: 707-994-2920 Fax: 707-994-2917 | |
Marc R Shapiro Medical Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3400 Emerson St, Suite A, Clearlake, CA 95422 Phone: 707-994-7241 Fax: 707-994-0870 | |
Lake County Tribal Health Consortium, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14678 Lakeshore Boulevard, Clearlake, CA 95453 Phone: 707-262-8382 | |
Adventist Health Clear Lake Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15230 Lakeshore Drive, Clearlake, CA 95422 Phone: 707-995-4500 Fax: 707-995-2401 |