| Fremont Medical Group, Inc. | |
|
734 Mowry Ave Fremont CA 94536-4115 | |
| (510) 793-3033 | |
| (510) 793-4952 |
| Full Name | Fremont Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 734 Mowry Ave, Fremont, California |
| Authorized Official Name and Position | Janis Shikano (OFFICE MANAGER) |
| Authorized Official Contact | 5107933033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fremont Medical Group, Inc. 734 Mowry Ave Fremont CA 94536-4115 Ph: (510) 793-3033 | Fremont Medical Group, Inc. 734 Mowry Ave Fremont CA 94536-4115 Ph: (510) 793-3033 |
| NPI Number | 1528009396 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8820157340 |
|---|---|
| Medicare Enrollment ID | O20081112000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528009396 | NPI | - | NPPES |
| GR0077610 | Medicaid | CA | |
| ZZZ46056Z | Other | CA | BLUE SHIELD |
| Provider Name | Sukhwinder Sandhu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063456457 PECOS PAC ID: 4082773502 Enrollment ID: I20081112000711 |
| Provider Name | Kenneth A Kelsen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538292321 PECOS PAC ID: 4082771308 Enrollment ID: I20090331000368 |
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