Healthcare Provider Details
I. General information
NPI: 1538959424
Provider Name (Legal Business Name): TPIRC MEDICAL FOUNDATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2191 MOWRY AVE STE 600B
FREMONT CA
94538-1702
US
IV. Provider business mailing address
PO BOX 2246
SEAL BEACH CA
90740-1246
US
V. Phone/Fax
- Phone: 560-490-9900
- Fax:
- Phone: 562-490-9900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0201X |
| Taxonomy | Pediatric Allergy/Immunology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANOOPJIT
LOHARA
Title or Position: CFO
Credential:
Phone: 562-353-5907