1275538530 NPI number — ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI

Table of content: (NPI 1275538530)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275538530 NPI number — ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI VALLEY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275538530
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 845755
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90084-5755
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-771-8600
Provider Business Mailing Address Fax Number:
661-771-8399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 MAGELLAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561-1380
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-771-8600
Provider Business Practice Location Address Fax Number:
661-771-8399
Provider Enumeration Date:
06/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WELLS
Authorized Official First Name:
JASON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
707-456-3010

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ZZT30446F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: RHM13977F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: RHM13979F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: RHM08620F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: BCP13979F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: BCP13977F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: LTC30446F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZT40446F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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