Provider Demographics
NPI:1285681809
Name:FREMONT ORTHOPAEDIC MEDICAL GROUP, APC
Entity Type:Organization
Organization Name:FREMONT ORTHOPAEDIC MEDICAL GROUP, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-896-0025
Mailing Address - Street 1:38690 STIVERS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5336
Mailing Address - Country:US
Mailing Address - Phone:510-896-0025
Mailing Address - Fax:510-742-9334
Practice Address - Street 1:38690 STIVERS ST
Practice Address - Street 2:SUITE A
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5336
Practice Address - Country:US
Practice Address - Phone:510-896-0025
Practice Address - Fax:510-742-9334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ49013ZMedicare ID - Type Unspecified