Healthcare Provider Details

I. General information

NPI: 1427089754
Provider Name (Legal Business Name): WASHINGTON TOWNSHIP HOSPITAL DEVELOPMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MOWRY AVE SUITE 212
FREMONT CA
94538-1605
US

IV. Provider business mailing address

2500 MOWRY AVE SUITE 212
FREMONT CA
94538-1605
US

V. Phone/Fax

Practice location:
  • Phone: 510-608-6174
  • Fax: 510-745-6435
Mailing address:
  • Phone: 510-608-6174
  • Fax: 510-745-6435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number140000653
License Number StateCA

VIII. Authorized Official

Name: MS. NANCY FARBER
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 510-745-6500