Healthcare Provider Details

I. General information

NPI: 1669880787
Provider Name (Legal Business Name): ADVENTIST HEALTH PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E CESAR E CHAVEZ AVE #3000
LOS ANGELES CA
90033-2424
US

IV. Provider business mailing address

1530 E CHEVY CHASE DR STE 110
GLENDALE CA
91206-4139
US

V. Phone/Fax

Practice location:
  • Phone: 323-987-1200
  • Fax: 323-987-1212
Mailing address:
  • Phone: 818-265-5411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: ADRIAN SERNA
Title or Position: CFO
Credential:
Phone: 916-865-1865