Provider Demographics
NPI:1902873136
Name:ADVENTIST ST. HELENA OB/GYN CLINIC
Entity Type:Organization
Organization Name:ADVENTIST ST. HELENA OB/GYN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL GROUP COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:W
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-968-2870
Mailing Address - Street 1:935 TRANCAS ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2932
Mailing Address - Country:US
Mailing Address - Phone:707-253-1135
Mailing Address - Fax:
Practice Address - Street 1:935 TRANCAS ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2932
Practice Address - Country:US
Practice Address - Phone:707-253-1135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ43091ZMedicare ID - Type Unspecified