Adventist Health Clear Lake

LBN: Adventist Health Clearlake Hospital Inc.
Adventist Health Clear Lake is an health care organization with primary practice located at 15630 18Th Ave , Clearlake CA 95422-6710. The organization recently has only one registered license in Hospitals / Critical Access, which is considered as the primary health care specialty. Adventist Health Clearlake Hospital Inc. can be contacted via phone (707) 994-6486, or through Howe, Judson H.E. via phone (707) 456-3010.

Contact Information

Primary practice address
15630 18Th Ave Clearlake CA 95422-6710
Phone: (707) 994-6486
Fax: (707) 995-3631
Website:
Map and Directions
Authorized official contact:
Name: Howe, Judson H.E.
Phone: (707) 456-3010

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Critical Access 282NC0060X 110000174 California

Profile Details

NPI number 1124018031
LBN Legal business name Adventist Health Clearlake Hospital Inc.
DBA Doing business as Adventist Health Clear Lake
Authorized official Howe, Judson H.E.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2005
Last updated May 29th, 2024 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124018031 NPPES
California MEDICAID HSP40539G
California MEDICAID ZZR00539G
California Other ZZZC1702Z

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