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FREMONT DERMATOLOGY MEDICAL OFFICE NPI 1841487337


NPI Information

NPI: 1841487337
Provider Name: FREMONT DERMATOLOGY MEDICAL OFFICE
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
39210 STATE ST STE 218
FREMONT, CA
ZIP 94538
Phone: (510) 790-0477
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FREMONT DERMATOLOGY MEDICAL OFFICE 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 DERMATOLOGY MEDICAL OFFICE NPI is 1841487337. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

39210 STATE ST STE 218
FREMONT, CA
ZIP 94538-456
Phone: (510) 790-0477

The provider's authorized official is David C Gorsulowsky .
The authorized official title is Physician and has the following contact phone number (510) 790-0477.

The enumeration date for this NPI number is 9/27/2007 and was last updated on 9/26/2008.


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
1174400000XSpecialistC042190CALIFORNIAYes

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
1=========OTHERCALIFORNIATAX IDENTIFICATION NUMBER
2ZZZ43507ZMEDICARE PINCALIFORNIA
3A37754OTHERCALIFORNIAUPIN
4070008967OTHERCALIFORNIARAILROAD MEDICARE ID

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

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