Provider Demographics
NPI:1710024898
Name:INYO COUNTY HEALTH & HUMAN SERVICES HEALTH DIVISION
Entity Type:Organization
Organization Name:INYO COUNTY HEALTH & HUMAN SERVICES HEALTH DIVISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INYO COUNTY HEALTH & HUMAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-873-3305
Mailing Address - Street 1:PO DRAWER H
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:CA
Mailing Address - Zip Code:93514
Mailing Address - Country:US
Mailing Address - Phone:760-878-0241
Mailing Address - Fax:760-878-0266
Practice Address - Street 1:207A WEST SOUTH STREET
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514
Practice Address - Country:US
Practice Address - Phone:760-873-7868
Practice Address - Fax:760-873-7800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INYO COUNTY HEALTH & HUMAN SERVICES HEALTH DIVISION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-30
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251K00000X
251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA90595572E05164Medicare UPIN
CA90595572505164Medicare UPIN