Provider Demographics
NPI:1194856443
Name:COUNTY OF FRESNO
Entity Type:Organization
Organization Name:COUNTY OF FRESNO
Other - Org Name:DEPARTMENT OF PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:POMAVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, REHS
Authorized Official - Phone:559-600-3200
Mailing Address - Street 1:PO BOX 11867
Mailing Address - Street 2:ADMINISTRATION, 6TH FLOOR
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93775-1867
Mailing Address - Country:US
Mailing Address - Phone:559-600-3200
Mailing Address - Fax:559-600-7687
Practice Address - Street 1:1221 FULTON MALL
Practice Address - Street 2:ADMINISTRATION, 6TH FLOOR
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1915
Practice Address - Country:US
Practice Address - Phone:559-600-3200
Practice Address - Fax:559-600-7687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health