1033247622 NPI number — ADVENTIST HEALTH DELANO

Table of content: (NPI 1033247622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033247622 NPI number — ADVENTIST HEALTH DELANO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVENTIST HEALTH DELANO
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:
DELANO REGIONAL MEDICAL CENTER
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:
1033247622
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1401 GARCES HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELANO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93215-3690
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-721-5375
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 GARCES HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DELANO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93215-3690
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-721-5375
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BUTLER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
661-721-5209

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  120000180 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 282N00000X , with the licence number: 120000180 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: ZZT30608G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ZZT06426G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: LTC70006G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com