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General NPI Number Information
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NPI Number | 1821057407
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Entity Type | Organization
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Legal Business Name | ARBOR VITA CORPORATION
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 05/27/2022
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Provider Practice Location Address
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Address Line | 48371 FREMONT BLVD STE 101
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City | FREMONT
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State | CA
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Zip | 94538-6554
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Country | US
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Telephone | 650-793-3686
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Fax | 510-573-4758
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Provider Business Mailing Address
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Address Line | 48371 FREMONT BLVD STE 101
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City | FREMONT
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State | CA
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Zip | 94538-6554
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Country | US
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Telephone | 650-793-3686
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Fax | 510-573-4758
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Authorized Official
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Title or Position | CEO
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Name | PETER LU
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Credential | MD
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Telephone | 650-793-3686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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