Organization
ADVENTIST HEALTH CLEARLAKE HOSPITAL INC
Active
Other names
Adventist Health Clear Lake
Organization subpart
No
Provider details
NPI number
Authorized official
PARKER J PRIDGEN (PRESIDENT)
(707) 467-5200
Entity
Organization
Contact information
Practice address
487 S MAIN ST, LAKEPORT, CA 95453-5315
(707) 263-4631
Mailing address
PO BOX 888837, LOS ANGELES, CA 90088-8837
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HSP40301F
—
CA
Enumeration date
11/09/2006
Last updated
09/15/2025
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