Healthcare Provider Details

I. General information

NPI: 1316866452
Provider Name (Legal Business Name): TUOLUMNE ME-WUK INDIAN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14520 MONO WAY STE 100
SONORA CA
95370-7828
US

IV. Provider business mailing address

14520 MONO WAY STE 100
SONORA CA
95370-7828
US

V. Phone/Fax

Practice location:
  • Phone: 209-928-5407
  • Fax: 209-928-5413
Mailing address:
  • Phone: 209-928-5407
  • Fax: 209-928-5413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOO YEUN HALLIDAY
Title or Position: PHARMACY DIRECTOR
Credential: PHARMD
Phone: 209-928-5407