Provider Demographics
NPI:1669360681
Name:WASHINGTON TOWNSHIP MEDICAL FOUNDATION
Entity type:Organization
Organization Name:WASHINGTON TOWNSHIP MEDICAL FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-248-1499
Mailing Address - Street 1:39300 CIVIC CENTER DR STE 370
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2397
Mailing Address - Country:US
Mailing Address - Phone:510-248-1000
Mailing Address - Fax:
Practice Address - Street 1:2682 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1619
Practice Address - Country:US
Practice Address - Phone:510-248-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASHINGTON TOWNSHIP MEDICAL FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care