Healthcare Provider Details

I. General information

NPI: 1508225806
Provider Name (Legal Business Name): EMANUEL ALCANTAR JARAMILLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date: 04/06/2018
Reactivation Date: 04/17/2018

III. Provider practice location address

39400 PASEO PADRE PKWY
FREMONT CA
94538-2310
US

IV. Provider business mailing address

39400 PASEO PADRE PKWY
FREMONT CA
94538-2310
US

V. Phone/Fax

Practice location:
  • Phone: 510-248-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA165759
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: