| Adventist Health Clearlake Hospital Inc. | |
|
5125 Skyway Paradise CA 95969-5624 | |
| (530) 872-2000 | |
| (530) 876-7952 |
| Full Name | Adventist Health Clearlake Hospital Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 5125 Skyway, Paradise, California |
| Authorized Official Name and Position | Parker J Pridgen (PRESIDENT) |
| Authorized Official Contact | 7074675200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adventist Health Clearlake Hospital Inc. Po Box 888837 Los Angeles CA 90088-8837 Ph: () - | Adventist Health Clearlake Hospital Inc. 5125 Skyway Paradise CA 95969-5624 Ph: (530) 872-2000 |
| NPI Number | 1912092792 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 09/15/2025 |
| Medicare PECOS PAC ID | 3072421197 |
|---|---|
| Medicare Enrollment ID | O20200402000632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912092792 | NPI | - | NPPES |
| RHM08604F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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