Healthcare Provider Details

I. General information

NPI: 1295800415
Provider Name (Legal Business Name): CHOWCHILLA MEMORIAL HEALTHCARE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 12/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 HOSPITAL DR
CHOWCHILLA CA
93610-2041
US

IV. Provider business mailing address

285 HOSPITAL DR
CHOWCHILLA CA
93610-2041
US

V. Phone/Fax

Practice location:
  • Phone: 559-665-3781
  • Fax: 559-665-7195
Mailing address:
  • Phone: 559-665-3781
  • Fax: 559-665-7195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number040000083
License Number StateCA

VIII. Authorized Official

Name: MS. CATHY J FLORES
Title or Position: CEO
Credential:
Phone: 559-665-3781