Healthcare Provider Details

I. General information

NPI: 1669463642
Provider Name (Legal Business Name): OMNI SURGICENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 MOWRY AVE
FREMONT CA
94538-1730
US

IV. Provider business mailing address

1860 MOWRY AVENUE SUITE 402
FREMONT CA
94538-1730
US

V. Phone/Fax

Practice location:
  • Phone: 510-284-4140
  • Fax: 510-284-4145
Mailing address:
  • Phone: 510-284-4140
  • Fax: 510-284-4145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. RAMESH KARIPINENI
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 510-284-4140