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General NPI Number Information
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NPI Number | 1417032921
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Entity Type | Organization
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Legal Business Name | NORTHERN INYO HEALTHCARE DISTRICT
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 153 PIONEER LN STE B
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City | BISHOP
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State | CA
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Zip | 93514-2517
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Country | US
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Telephone | 760-873-2849
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Fax | 760-872-5800
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Provider Business Mailing Address
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Address Line | 150 PIONEER LN
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City | BISHOP
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State | CA
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Zip | 93514-2556
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Country | US
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Telephone | 760-873-5811
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Fax | 760-872-5800
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. CHRISTIAN WALLIS
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Credential |
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Telephone | 760-873-2838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 240000179
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License Number State | CA
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