Healthcare Provider Details

I. General information

NPI: 1659433191
Provider Name (Legal Business Name): TOIYABE INDIAN HEALTH PROJECT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N SEE VEE LN
BISHOP CA
93514-8130
US

IV. Provider business mailing address

250 N SEE VEE LN
BISHOP CA
93514-8130
US

V. Phone/Fax

Practice location:
  • Phone: 760-873-8464
  • Fax: 760-503-4174
Mailing address:
  • Phone: 760-873-8464
  • Fax: 760-873-3908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License NumberEXEMPT
License Number StateCA

VIII. Authorized Official

Name: EARL W. LENT III
Title or Position: CEO
Credential:
Phone: 760-873-8464