Healthcare Provider Details

I. General information

NPI: 1093720609
Provider Name (Legal Business Name): TOIYABE INDIAN HEALTH PROJECT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
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: 760-873-4721
  • Fax: 760-503-0211
Mailing address:
  • Phone: 760-873-4721
  • Fax: 760-873-6127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. EMETERIO MEDINA
Title or Position: PHARMD, PIC
Credential:
Phone: 760-873-4721