Healthcare Provider Details

I. General information

NPI: 1205871670
Provider Name (Legal Business Name): COUNTY OF TULARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1062 S K ST
TULARE CA
93274-6421
US

IV. Provider business mailing address

5957 S MOONEY BLVD
VISALIA CA
93277-9394
US

V. Phone/Fax

Practice location:
  • Phone: 559-685-2500
  • Fax: 559-685-2514
Mailing address:
  • Phone: 559-624-8000
  • Fax: 559-737-4697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN ELLIOTT
Title or Position: DEPUTY DIRECTOR OF HEALTH
Credential:
Phone: 559-624-8000