Healthcare Provider Details

I. General information

NPI: 1477919033
Provider Name (Legal Business Name): ADVENTIST HEALTH PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2016
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MARCELA DR
WILLITS CA
95490-5769
US

IV. Provider business mailing address

PO BOX 888794
LOS ANGELES CA
90088-8794
US

V. Phone/Fax

Practice location:
  • Phone: 707-459-6115
  • Fax: 707-459-1345
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: ARBY NAHAPETIAN
Title or Position: PRESIDENT
Credential:
Phone: 702-271-4998