Provider Demographics
NPI:1649664848
Name:NORTHERN INYO ASSOCIATES
Entity type:Organization
Organization Name:NORTHERN INYO ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-873-2838
Mailing Address - Street 1:152 PIONEER LN
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2563
Mailing Address - Country:US
Mailing Address - Phone:760-873-5811
Mailing Address - Fax:760-873-2115
Practice Address - Street 1:152 PIONEER LN
Practice Address - Street 2:SUITE D
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2563
Practice Address - Country:US
Practice Address - Phone:760-872-1606
Practice Address - Fax:760-872-3463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center