| Adventist Health Clearlake Hospital, Inc | |
|
6300 E. Highway 20 Lucerne CA 95458 | |
| (707) 274-9299 | |
| Not Available |
| Full Name | Adventist Health Clearlake Hospital, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6300 E. Highway 20, Lucerne, California |
| Authorized Official Name and Position | Parker J Pridgen (PRESIDENT) |
| Authorized Official Contact | 7074563010 |
| 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 6300 E. Highway 20 Lucerne CA 95458 Ph: (707) 274-9299 |
| NPI Number | 1093274508 |
|---|---|
| Provider Enumeration Date | 03/14/2019 |
| Last Update Date | 09/15/2025 |
| Medicare PECOS PAC ID | 3072421197 |
|---|---|
| Medicare Enrollment ID | O20190726002811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093274508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Lucerne Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6300 E. Hwy 20, Lucerne, CA 95458 Phone: 707-274-9299 Fax: 707-274-9297 |