Healthcare Provider Details

I. General information

NPI: 1992701650
Provider Name (Legal Business Name): CALIFORNIA CARDIOVASCULAR CONSULTANTS MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MOWRY AVE STE 309
FREMONT CA
94538-1722
US

IV. Provider business mailing address

1900 MOWRY AVE STE 309
FREMONT CA
94538-1722
US

V. Phone/Fax

Practice location:
  • Phone: 510-796-0222
  • Fax: 510-796-7760
Mailing address:
  • Phone: 510-796-0222
  • Fax: 510-796-7760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number024681
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number024681
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number024681
License Number StateCA

VIII. Authorized Official

Name: DR. ASHIT JAIN
Title or Position: PRESIDENT
Credential: MD
Phone: 510-796-0222