Healthcare Provider Details
I. General information
NPI: 1164403044
Provider Name (Legal Business Name): FRESNO COUNTY EOC HEALTH SERVICES CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2005
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1047 R ST
FRESNO CA
93721-1312
US
IV. Provider business mailing address
1047 R ST
FRESNO CA
93721-1312
US
V. Phone/Fax
- Phone: 559-499-1690
- Fax: 559-499-1697
- Phone: 559-499-1690
- Fax: 559-499-1697
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251X00000X |
| Taxonomy | Supports Brokerage Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0005X |
| Taxonomy | Ambulatory Family Planning Facility |
| License Number | G 32293 |
| License Number State | CA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332U00000X |
| Taxonomy | Home Delivered Meals |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
WILLIAM
DOWIS
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 559-499-1690