MEDICARE: ADVENTIST HEALTH PHYSICIANS NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1528440898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVENTIST HEALTH PHYSICIANS NETWORK

Provider Business Mailing Address
First Line	:	1530 E CHEVY CHASE DR STE 110
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-4139
Country	:	US
Telephone Number	:	818-265-5411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1934 W BEVERLY BLVD
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-3957
Country	:	US
Telephone Number	:	323-558-7470
Fax Number	:	323-558-7474

Authorized Official
Title or Position	:	C.F.O
Name	:	ADRIAN SERNA
Credential	:
Telephone Number	:	916-865-1865

Provider Enumeration Date	:	06/23/2015
Last Update Date	:	11/27/2017

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