NPIMap

Organization Active NPI

Northern Inyo Healthcare District

  • Student Health Clinic/Center
  • Bishop, CA
National Provider Identifier
1104431980
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
NORTHERN INYO HEALTHCARE DISTRICT
Practice address
301 N Fowler St
Bishop, CA 93514-2609
Phone
(760) 873-6373
Fax
(760) 873-3266
NPI assigned
Sep 9, 2020
Organization subpart
Yes
Parent organization
NORTHERN INYO HEALTHCARE DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christian Wallis
Title
Chief Executive Officer
Phone
(760) 873-2838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

301 N Fowler St
Bishop, CA 93514-2609

Mailing address

150 Pioneer LN
Bishop, CA 93514-2556
Phone (760) 873-5811

Other names 1

  • Bronco Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2196700Bronco Clinic301 North Fowler, Bishop, CA 93514Certificate of waiverOct 18, 2026

National Provider Directory

National Provider Directory
Tax ID family
Northern Inyo HSP Path6 organizations share this tax ID, including this one
Part of
Northern Inyo HSP Path

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2fc0be4f-8d9d-4f3f-89d9-ee59fb2aaa86/

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1104431980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142556",
            "telephone_number": "760-873-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N FOWLER ST",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142609",
            "telephone_number": "760-873-6373",
            "fax_number": "760-873-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN INYO HEALTHCARE DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN INYO HEALTHCARE DISTRICT",
        "enumeration_date": "2020-09-09",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "760-873-2838"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bronco Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bronco Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bishop, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.