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General NPI Number Information
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NPI Number | 1629411665
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Entity Type | Organization
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Legal Business Name | FAME PUBLIC CHARTER SCHOOL
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 39899 BALENTINE DR SUITE 335
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City | NEWARK
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State | CA
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Zip | 94560-5355
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Country | US
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Telephone | 510-687-9111
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Fax | 510-687-9574
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Provider Business Mailing Address
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Address Line | 39899 BALENTINE DR SUITE 335
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City | NEWARK
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State | CA
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Zip | 94560-5355
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Country | US
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Telephone | 510-687-9111
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Fax | 510-687-9574
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. IQBAL MALIK
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Credential |
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Telephone | 510-490-9990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 01100170109835
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License Number State | CA
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