Healthcare Provider Details

I. General information

NPI: 1376840462
Provider Name (Legal Business Name): ADVENTIST HEALTH PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2011
Last Update Date: 02/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 ADAMS ST SUITE 500
SAINT HELENA CA
94574-1148
US

IV. Provider business mailing address

1001 ADAMS ST
SAINT HELENA CA
94574-1107
US

V. Phone/Fax

Practice location:
  • Phone: 707-963-5294
  • Fax: 707-963-3271
Mailing address:
  • Phone: 707-968-2865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF CONKLIN
Title or Position: PRESIDENT
Credential:
Phone: 916-789-4209