Basic Information
| Provider Information | |||||||||
| NPI: | 1679973267 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVENTIST HEALTH PHYSICIANS NETWORK | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1530 E CHEVY CHASE DR STE 110 | ||||||||
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| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912064139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8182655411 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1701 E CESAR E CHAVEZ AVE | ||||||||
| Address2: | #456 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900332464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3239871200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2014 | ||||||||
| LastUpdateDate: | 11/27/2017 | ||||||||
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| AuthorizedOfficialLastName: | SERNA | ||||||||
| AuthorizedOfficialFirstName: | ADRIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9168651865 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.