Healthcare Provider Details

I. General information

NPI: 1134169345
Provider Name (Legal Business Name): FREMONT PEDIATRIC MED GRP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43971 BOSCELL ROAD
FREMONT CA
94538
US

IV. Provider business mailing address

PO BOX 906
SALIDA CA
95368
US

V. Phone/Fax

Practice location:
  • Phone: 510-979-0603
  • Fax: 510-979-0798
Mailing address:
  • Phone: 209-577-9900
  • Fax: 209-577-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SEYMOUR STEINMETZ
Title or Position: PRESIDENT
Credential: MD
Phone: 570-979-0603