MEDICARE: OMNI SURGICENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center		CA

General Provider Information

NPI Number	:	1669463642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNI SURGICENTER

Provider Business Mailing Address
First Line	:	1860 MOWRY AVENUE SUITE 402
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-1730
Country	:	US
Telephone Number	:	510-284-4140
Fax Number	:	510-284-4145

Provider Business Practice Location Address
First Line	:	1860 MOWRY AVE
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-1730
Country	:	US
Telephone Number	:	510-284-4140
Fax Number	:	510-284-4145

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. RAMESH KARIPINENI
Credential	:	M.D.
Telephone Number	:	510-284-4140

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	08/22/2020

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Directions to “OMNI SURGICENTER ” Practice Location

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