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ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
NPI 1154646982
Internal Medicine - Cardiovascular Disease in Clearlake, CA

Active since April 05, 2010CLIA Certified · 3 labs
15322 LAKESHORE DR, SUITE 203, CLEARLAKE, CA 95422(707) 968-2809(707) 963-9185 Get Directions Write a Review

NPPES record last updated: April 5, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Adventist Health California Medical Group, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC. (NPI 1154646982) is a healthcare organization registered as a cardiovascular disease in Clearlake, California and active in the NPI registry since April 2010. The organization holds 3 active CLIA laboratory certificates and lists Kaye A Donnelly, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1154646982
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Location Address15322 LAKESHORE DR, SUITE 203Clearlake, CA 95422-9814
Mailing Address1572 Railroad Ave, Suite 2Saint Helena, CA 94574-1169 · (707) 968-2809 · Fax (707) 963-9185
Phone(707) 968-2809
Fax(707) 963-9185
Organization SubpartNo
Authorized OfficialKaye A DonnellyCredentialing Coordinator · (707) 968-2809
Enumeration DateApril 5, 2010
✔ NPI 1154646982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in CA · C32535
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedUrologyTaxonomy 208800000X · License A106559 (CA)
15322 LAKESHORE DR, Clearlake, CA 95422
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2289609

Adventist Health Medical Office - Hilltop #101 · Clearlake, CA
Active · expires Sep 12, 2027
CLIA Number05D2289609
Laboratory TypeRural Health Clinic
Certificate Effective DateSeptember 13, 2025
Certificate Expiration DateSeptember 12, 2027
Laboratory DirectorParviz Talebi
Laboratory Phone(707) 995-5778
Laboratory LocationAdventist Health Medical Office - Hilltop #10115322 Lakeshore Dr #101, Clearlake, CA 95422
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2286726

Adventist Health Medical Office - Hilltop # 103 · Clearlake, CA
Active · expires Aug 1, 2027
CLIA Number05D2286726
Laboratory TypeRural Health Clinic
Certificate Effective DateAugust 2, 2025
Certificate Expiration DateAugust 1, 2027
Laboratory DirectorParviz Talebi
Laboratory Phone(707) 995-5778
Laboratory LocationAdventist Health Medical Office - Hilltop # 10315322 Lakeshore Drive # 103, Clearlake, CA 95422
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2169110

Adventist Health Medical Office - Hilltop #102 · Clearlake, CA
Active · expires Jul 15, 2027
CLIA Number05D2169110
Laboratory TypeRural Health Clinic
Certificate Effective DateJuly 16, 2025
Certificate Expiration DateJuly 15, 2027
Laboratory DirectorParviz Talebi
Laboratory Phone(707) 995-5778
Laboratory LocationAdventist Health Medical Office - Hilltop #10215322 Lakeshore Dr, Clearlake, CA 95422
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ADVENTIST HEALTH PHYSICIAN NETWORK
Family Medicine
15322 LAKESHORE DR, SUITE 202
CLEARLAKE, CA 95422
Lake County (707) 994-0305
ADVENTIST HEALTH PHYSICIANS NETWORK
Obstetrics & Gynecology
15322 LAKESHORE DR
CLEARLAKE, CA 95422
Lake County (707) 994-2030
MICHAEL D. SHEPHERD M.D. INC.
Family Medicine
15322 LAKESHORE DR, STE. 201
CLEARLAKE, CA 95422
Lake County (707) 994-2920
DR. JERRY EDWARD DOUGLAS MD
Family Medicine
15322 LAKESHORE DR, SUITE 202
CLEARLAKE, CA 95422
Lake County (707) 994-0303
ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Family Medicine
15322 LAKESHORE DR, SUITE 201
CLEARLAKE, CA 95422
Lake County (707) 994-2920
MARK FREEMAN, MD
Family Medicine
15322 LAKESHORE DR, SUITE 101
CLEARLAKE, CA 95422
Lake County (707) 995-1362
ST. HELENA OB/GYN CLINIC
Specialist
15322 LAKESHORE DR, SUITE 102
CLEARLAKE, CA 95422
Lake County (707) 995-0193
ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Family Medicine
15322 LAKESHORE DR, SUITE 202
CLEARLAKE, CA 95422
Lake County (707) 994-0305

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adventist Health California Medical Group, Inc.'s NPI number?

The NPI number for Adventist Health California Medical Group, Inc. is 1154646982. It was assigned to this organization in the NPPES registry on April 5, 2010.

Where is Adventist Health California Medical Group, Inc. located?

Adventist Health California Medical Group, Inc. is located at 15322 Lakeshore Dr Suite 203, Clearlake, CA 95422. The listed phone number is (707) 968-2809.

What is Adventist Health California Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Adventist Health California Medical Group, Inc. hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Adventist Health California Medical Group, Inc. was last updated on April 5, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.