| Mowry I | |
|
2299 Mowry Ave Ste 3b Fremont CA 94538-1621 | |
| (510) 770-8133 | |
| (510) 713-6682 |
| Full Name | Mowry I |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2299 Mowry Ave Ste 3b, Fremont, California |
| Authorized Official Name and Position | Jaghet Sheth (CEO) |
| Authorized Official Contact | 5102525808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mowry I 40910 Fremont Blvd Fremont CA 94538-4375 Ph: (510) 770-8040 | Mowry I 2299 Mowry Ave Ste 3b Fremont CA 94538-1621 Ph: (510) 770-8133 |
| NPI Number | 1649493180 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 07/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649493180 | NPI | - | NPPES |
| 140000481 | Other | LICENSE # | |
| FHC70603F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 140000481 (California) | Primary |
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