MEDICARE: ADVENTIST HEALTH PHYSICIANS NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center		CA

General Provider Information

NPI Number	:	1780073957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVENTIST HEALTH PHYSICIANS NETWORK

Provider Business Mailing Address
First Line	:	PO BOX 888974
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90088-8974
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4415 SONOMA HWY
Second Line	:	SUITE D
City	:	SANTA ROSA
State	:	CA
Zip	:	95409-7100
Country	:	US
Telephone Number	:	707-963-7200
Fax Number	:	707-963-7203

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ADRIAN SERNA
Credential	:
Telephone Number	:	916-406-0087

Provider Enumeration Date	:	01/12/2015
Last Update Date	:	01/14/2022

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