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FREMONT PAIN TREAMTMENT CENTER NPI 1083950380


NPI Information

NPI: 1083950380
Provider Name: FREMONT PAIN TREAMTMENT CENTER
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 05D1097382

Address:
656 MOWRY AVE
FREMONT, CA
ZIP 94536
Phone: (510) 818-9237
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FREMONT PAIN TREAMTMENT CENTER is a specialist in Fremont, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. FREMONT PAIN TREAMTMENT CENTER NPI is 1083950380. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

656 MOWRY AVE
FREMONT, CA
ZIP 94536-113
Phone: (510) 818-9237
Fax: (510) 818-9222

The provider's authorized official is Tulsidas Gwalani .
The authorized official title is Owner and has the following contact phone number (510) 818-9237.

The CLIA number assigned to this NPI record is 05D1097382 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2012 and was last updated on 12/14/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistA76626CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100A766261OTHERCALIFORNIAPTEN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.