| Adventist Health Clear Lake | |
|
487 S Main St Lakeport CA 95453-5315 | |
| (707) 263-4631 | |
| Not Available |
| Full Name | Adventist Health Clear Lake |
|---|---|
| Speciality | Clinic/Center |
| Location | 487 S Main St, Lakeport, California |
| Authorized Official Name and Position | Colleen Assavapisitkul (PRESIDENT) |
| Authorized Official Contact | 7079955827 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adventist Health Clear Lake Po Box 888837 Los Angeles CA 90088-8837 Ph: () - | Adventist Health Clear Lake 487 S Main St Lakeport CA 95453-5315 Ph: (707) 263-4631 |
| NPI Number | 1417027095 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 12/20/2022 |
| Medicare PECOS PAC ID | 3072421197 |
|---|---|
| Medicare Enrollment ID | O20200110001501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417027095 | NPI | - | NPPES |
| HSP40301F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Upper Lake Clinic Rhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5176 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-5001 Fax: 707-262-5006 | |
Sutter Lakeside Hospital Mobile Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5176 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-5000 Fax: 707-262-5005 | |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55 1st St, Ste 210, Lakeport, CA 95453 Phone: 707-462-1516 Fax: 707-462-1178 | |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 11th St, Lakeport, CA 95453 Phone: 707-263-3746 | |
Tribal Health Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 359 Lakeport Blvd, Lakeport, CA 95453 Phone: 707-533-2700 Fax: 707-263-5400 | |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5108 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-1840 Fax: 707-262-5844 | |
Sutter Bay Hospitals Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5196 Hill Rd E, Suite 300, Lakeport, CA 95453 Phone: 707-263-6885 Fax: 707-263-6624 |