NPIMap

Organization Active NPI

Northern Inyo Healthcare District

  • Diagnostic Radiology Physician
  • Bishop, CA
National Provider Identifier
1679997175
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
240000179 Issued in CA
Legal business name
NORTHERN INYO HEALTHCARE DISTRICT
Practice address
150 Pioneer LN
Bishop, CA 93514-2556
Phone
(760) 873-5811
NPI assigned
Feb 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X 240000179 CA Primary

Addresses

Primary practice location

150 Pioneer LN
Bishop, CA 93514-2556

Mailing address

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

National Provider Directory

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

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1679997175",
    "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": "150 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142556",
            "telephone_number": "760-873-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN INYO HEALTHCARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "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": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "240000179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.