Healthcare Provider Details

I. General information

NPI: 1770539041
Provider Name (Legal Business Name): COMPREHENSIVE ALLERGY SERVICE MEDICAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1895 MOWRY AVE STE 118B
FREMONT CA
94538-1737
US

IV. Provider business mailing address

43575 MISSION BLVD STE 716
FREMONT CA
94539-5831
US

V. Phone/Fax

Practice location:
  • Phone: 510-200-0445
  • Fax: 844-898-6129
Mailing address:
  • Phone: 510-200-0445
  • Fax: 844-898-6129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SANJEEV JAIN
Title or Position: CEO/OWNER
Credential: MD
Phone: 408-476-0624