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General NPI Number Information
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NPI Number | 1194120600
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Entity Type | Organization
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Legal Business Name | FREMONT HEALTHCARE OPERATING COMPANY, LP
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 39022 PRESIDIO WAY
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City | FREMONT
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State | CA
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Zip | 94538-1221
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Country | US
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Telephone | 510-792-3743
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Fax | 510-793-6108
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Provider Business Mailing Address
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Address Line | 39022 PRESIDIO WAY
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City | FREMONT
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State | CA
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Zip | 94538-1221
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Country | US
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Telephone | 510-792-3743
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Fax | 510-793-6108
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Authorized Official
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Title or Position | REGIONAL FINANCIAL ANALYST
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Name | MRS. ANDREA SAAVEDRA
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Credential |
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Telephone | 707-208-1940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 020000025
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License Number State | CA
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