| Adventist Health Clear Lake | |
|
18990 Coyote Valley Rd Hidden Valley Lake CA 95467-8337 | |
| (707) 987-8344 | |
| Not Available |
| Full Name | Adventist Health Clear Lake |
|---|---|
| Speciality | Clinic/Center |
| Location | 18990 Coyote Valley Rd, Hidden Valley Lake, California |
| Authorized Official Name and Position | Judson H.e. Howe (PRESIDENT) |
| Authorized Official Contact | 7074563010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adventist Health Clear Lake Po Box 888837 Los Angeles CA 90088-8837 Ph: () - | Adventist Health Clear Lake 18990 Coyote Valley Rd Hidden Valley Lake CA 95467-8337 Ph: (707) 987-8344 |
| NPI Number | 1558737486 |
|---|---|
| Provider Enumeration Date | 08/14/2015 |
| Last Update Date | 05/29/2024 |
| Medicare PECOS PAC ID | 3072421197 |
|---|---|
| Medicare Enrollment ID | O20151029002536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558737486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 110000174 (California) | Primary |
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