| 3prong Health | |
|
39159 Paseo Padre Pkwy Ste 121 Fremont CA 94538-1600 | |
| (951) 801-2513 | |
| (951) 351-1104 |
| Full Name | 3prong Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 39159 Paseo Padre Pkwy Ste 121, Fremont, California |
| Authorized Official Name and Position | Deepak Kumar (CEO) |
| Authorized Official Contact | 5109521190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 3prong Health 39159 Paseo Padre Pkwy Ste 121 Fremont CA 94538-1600 Ph: (510) 952-1190 | 3prong Health 39159 Paseo Padre Pkwy Ste 121 Fremont CA 94538-1600 Ph: (951) 801-2513 |
| NPI Number | 1942866462 |
|---|---|
| Provider Enumeration Date | 05/10/2019 |
| Last Update Date | 10/10/2020 |
| Certification Date | 10/10/2020 |
| Medicare PECOS PAC ID | 5597178111 |
|---|---|
| Medicare Enrollment ID | O20201228002178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942866462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Deepak Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306257910 PECOS PAC ID: 7416179189 Enrollment ID: I20141112002597 |
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