Provider Demographics
NPI:1942507009
Name:ADVENTIST HEALTH PHYSICIANS NETWORK
Entity Type:Organization
Organization Name:ADVENTIST HEALTH PHYSICIANS NETWORK
Other - Org Name:MONTEITH AUSTIN, MD- HANFORD CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-789-4209
Mailing Address - Street 1:1524 W LACEY BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5965
Mailing Address - Country:US
Mailing Address - Phone:559-583-4695
Mailing Address - Fax:559-583-4300
Practice Address - Street 1:470 GREENFIELD AVE
Practice Address - Street 2:SUITE #202
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3576
Practice Address - Country:US
Practice Address - Phone:559-584-2759
Practice Address - Fax:559-584-2811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENTIST HEALTH PHYSICIANS NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-24
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty