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General NPI Number Information
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NPI Number | 1962687566
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Entity Type | Organization
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Legal Business Name | COLUMBIA ASTHMA & ALLERGY CLINIC
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 3448 MOWRY AVE
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City | FREMONT
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State | CA
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Zip | 94538
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Country | US
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Telephone | 510-373-3000
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Fax | 510-744-9959
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Provider Business Mailing Address
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Address Line | 3448 MOWRY AVE
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City | FREMONT
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State | CA
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Zip | 94538-1422
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Country | US
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Telephone | 510-373-3000
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Fax | 510-744-9959
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Authorized Official
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Title or Position | SENIOR CREDENTIALING SPECIALIST
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Name | KRISTINA FLETCHER
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Credential |
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Telephone | 360-940-0860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MD00040042
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License Number State | WA
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