Provider Demographics
NPI:1013286939
Name:ADVENTIST HEALTH PHYSICIANS NETWORK
Entity Type:Organization
Organization Name:ADVENTIST HEALTH PHYSICIANS NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SERNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-865-1865
Mailing Address - Street 1:9330 STOCKDALE HWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3614
Mailing Address - Country:US
Mailing Address - Phone:661-654-0400
Mailing Address - Fax:661-323-0889
Practice Address - Street 1:9330 STOCKDALE HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3614
Practice Address - Country:US
Practice Address - Phone:661-654-0400
Practice Address - Fax:661-323-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0088440Medicaid