Provider Demographics
NPI:1982755880
Name:WASHINGTON HOSPITAL CARDIOLOGY DEPT.
Entity Type:Organization
Organization Name:WASHINGTON HOSPITAL CARDIOLOGY DEPT.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR ASSOCIATE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:W
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-791-3438
Mailing Address - Street 1:2000 MOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1716
Mailing Address - Country:US
Mailing Address - Phone:510-745-6504
Mailing Address - Fax:510-745-6505
Practice Address - Street 1:2000 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1716
Practice Address - Country:US
Practice Address - Phone:510-745-6504
Practice Address - Fax:510-745-6505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ28826ZMedicare ID - Type UnspecifiedCARDIO DEPT PROV#