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General NPI Number Information
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NPI Number | 1003956061
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Entity Type | Organization
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Legal Business Name | HARMOHINDER S ATHWAL INC.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 39001 SUNDALE DR
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City | FREMONT
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State | CA
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Zip | 94538-2005
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Country | US
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Telephone | 510-574-4860
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Fax | 510-651-5803
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Provider Business Mailing Address
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Address Line | 39885 PASEO PADRE PKWY
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City | FREMONT
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State | CA
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Zip | 94538-2974
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Country | US
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Telephone | 510-651-5808
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Fax | 510-651-5803
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARMOHINDER SINGH ATHWAL
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Credential | MD
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Telephone | 510-651-5808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | A81841
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License Number State | CA
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