Healthcare Provider Details

I. General information

NPI: 1174820344
Provider Name (Legal Business Name): ADVENTIST HEALTH PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 BUCHANAN ST SUITE. 310
SAN FRANCISCO CA
94123-5410
US

IV. Provider business mailing address

3727 BUCHANAN ST SUITE. 310
SAN FRANCISCO CA
94123-5410
US

V. Phone/Fax

Practice location:
  • Phone: 707-968-0670
  • Fax: 707-968-9580
Mailing address:
  • Phone: 707-968-0670
  • Fax: 707-968-9580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

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