Organization
ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYE A DONNELLY (CREDENTIALING COORDINATOR)
(707) 968-2809
Entity
Organization
Contact information
Practice address
15322 LAKESHORE DR, SUITE 203, CLEARLAKE, CA 95422-9814
(707) 968-2809
(707) 963-9185
Mailing address
1572 RAILROAD AVE, SUITE 2, SAINT HELENA, CA 94574-1169
(707) 968-2809
(707) 963-9185
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
C32535
CA
208800000X
Urology Physician
A106559
CA
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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