Healthcare Provider Details

I. General information

NPI: 1770910325
Provider Name (Legal Business Name): ADVENTIST HEALTH PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 W CYPRESS AVE #101
REEDLEY CA
93654-2113
US

IV. Provider business mailing address

PO BOX 2087
HANFORD CA
93232-2087
US

V. Phone/Fax

Practice location:
  • Phone: 323-454-4485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: KIRBY MCKAGUE
Title or Position: CFO
Credential:
Phone: 916-865-1790