Healthcare Provider Details

I. General information

NPI: 1508831629
Provider Name (Legal Business Name): CATHERINE M BEHRENS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 08/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1895 MOWRY AVE #103
FREMONT CA
94538
US

IV. Provider business mailing address

1895 MOWRY AVE #103
FREMONT CA
94538
US

V. Phone/Fax

Practice location:
  • Phone: 510-792-5990
  • Fax: 510-792-4141
Mailing address:
  • Phone: 510-792-5990
  • Fax: 510-792-4141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG050677
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: