Provider Demographics
NPI:1922189406
Name:FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Entity Type:Organization
Organization Name:FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Other - Org Name:COMMUNITY MEDICAL CENTER-OAKHURST RHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOSLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-324-4744
Mailing Address - Street 1:48677 VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:CA
Mailing Address - Zip Code:93644-9216
Mailing Address - Country:US
Mailing Address - Phone:559-459-1672
Mailing Address - Fax:559-459-1058
Practice Address - Street 1:48677 VICTORIA LN
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-9216
Practice Address - Country:US
Practice Address - Phone:559-459-1672
Practice Address - Fax:559-459-1058
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLOVIS COMMUNITY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-18
Last Update Date:2022-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA040000004261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058504Medicare Oscar/Certification