Healthcare Provider Details

I. General information

NPI: 1841531902
Provider Name (Legal Business Name): MISSION HOSPITALIST MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MOWRY AVE
FREMONT CA
94538-1716
US

IV. Provider business mailing address

2333 MOWRY AVE SUITE 300
FREMONT CA
94538-1625
US

V. Phone/Fax

Practice location:
  • Phone: 510-797-1111
  • Fax: 510-792-0795
Mailing address:
  • Phone: 510-796-0222
  • Fax: 510-796-7760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA35678
License Number StateCA

VIII. Authorized Official

Name: DR. ASHIT JAIN
Title or Position: CEO
Credential: M.D.
Phone: 510-796-0222