Provider Demographics
NPI:1154753002
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:
Authorized Official - First Name:KIRBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-865-1887
Mailing Address - Street 1:PO BOX 2087
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93232-2087
Mailing Address - Country:US
Mailing Address - Phone:916-865-1790
Mailing Address - Fax:
Practice Address - Street 1:1201 ROSE AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-3227
Practice Address - Country:US
Practice Address - Phone:559-583-4694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty