Provider Demographics
NPI:1174634216
Name:JOHN GIDDENS JR M.D. INC
Entity Type:Organization
Organization Name:JOHN GIDDENS JR M.D. INC
Other - Org Name:FREMONT URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIDDENS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:510-796-1000
Mailing Address - Street 1:PO BOX 1129
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-8129
Mailing Address - Country:US
Mailing Address - Phone:510-796-1000
Mailing Address - Fax:510-796-1050
Practice Address - Street 1:3161 WALNUT AVENUE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538
Practice Address - Country:US
Practice Address - Phone:510-796-1000
Practice Address - Fax:510-796-1050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty