Organization
ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYE A DONNELLY (SPECIALIST, CONTRACT COMPLIANCE)
(707) 968-2809
Entity
Organization
Contact information
Practice address
18990 COYOTE VALLEY RD, SUITE 5, HIDDEN VALLEY LAKE, CA 95467-8337
(707) 987-9024
(707) 987-9152
Mailing address
1001 ADAMS ST, SUITE 102, SAINT HELENA, CA 94574-1107
(707) 968-2809
(707) 963-9185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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