Organization Name: | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC |
NPI Number: | 1609222512 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID SANTOS (CEO) |
Mailing Address: | 501 E St Williams |
State: | CA US |
Postal Code: | 959875810 |
Phone Number: | 5304735641 |
Fax Number: | |
NPI Enumeration Date: | 05/10/2016 |
NPI Last Update Date: | 05/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | 110000174 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |