Provider Demographics
NPI:1033197801
Name:FOWLER MEDICAL CENTER INC
Entity Type:Organization
Organization Name:FOWLER MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BITUIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BERNARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-834-5341
Mailing Address - Street 1:210 E MERCED ST
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:CA
Mailing Address - Zip Code:93625-2313
Mailing Address - Country:US
Mailing Address - Phone:559-834-5341
Mailing Address - Fax:559-834-1234
Practice Address - Street 1:210 E MERCED ST
Practice Address - Street 2:
Practice Address - City:FOWLER
Practice Address - State:CA
Practice Address - Zip Code:93625-2313
Practice Address - Country:US
Practice Address - Phone:559-834-5341
Practice Address - Fax:559-834-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABCP03951GOtherBCEDP
053951OtherPTAN
CAHAP03951FOtherFPACT
CARHM03951GMedicaid
CARHM03951GMedicaid
053951Medicare PIN