Provider Demographics
NPI:1669463642
Name:OMNI SURGICENTER
Entity Type:Organization
Organization Name:OMNI SURGICENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KARIPINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-284-4140
Mailing Address - Street 1:1860 MOWRY AVENUE SUITE 402
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1730
Mailing Address - Country:US
Mailing Address - Phone:510-284-4140
Mailing Address - Fax:510-284-4145
Practice Address - Street 1:1860 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1730
Practice Address - Country:US
Practice Address - Phone:510-284-4140
Practice Address - Fax:510-284-4145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31825ZMedicare ID - Type UnspecifiedMEDICARE BILLING NUMBER