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General NPI Number Information
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NPI Number | 1184046864
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Entity Type | Organization
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Legal Business Name | ADVENTIST HEALTH PHYSICIANS NETWORK
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Dates
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Enumeration Date | 01/14/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 1808 VERDUGO BLVD #408
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City | GLENDALE
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State | CA
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Zip | 91208-1477
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Country | US
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Telephone | 818-952-5322
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2087
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City | HANFORD
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State | CA
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Zip | 93232-2087
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | KIRBY MCKAGUE
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Credential |
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Telephone | 916-865-1887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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