FREMONT DERMATOLOGY MEDICAL OFFICE (NPI# 1841487337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841487337 |
| Entity Type | Organization |
| Organization Name | FREMONT DERMATOLOGY MEDICAL OFFICE |
| Practice Address |
39210 State St Ste 218 Fremont CA 94538-1456 |
| Practice Telephone | 5107900477 |
| Mailing Telephone | 5107900477 |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2008-09-26 |
| Authorized Official Name | DR. DAVID C GORSULOWSKY (PHYSICIAN) |
| Authorized Official Telephone | 5107900477 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | C042190 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | UPIN | A37754 | 01 |
| CA | RAILROAD MEDICARE ID | 070008967 | 01 |
| Street Address |
39210 STATE ST STE 218 |
| City | FREMONT |
| State | CA |
| Zip Code | 94538-1456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394460 | Bay Area Kidney Care Medical Group Inc. | Clinic/Center | 39370 Mozart Terrace Unit 106, Fremont, CA 94538 | 2020-04-13 |
| 1740847284 | Gloria Ann Federico | Behavior Technician | 39210 State St., Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2019-05-21 |
| 1093270688 | Timothy Lorne Haynes | Chiropractor | 3775 Beacon Ave., Suite 200, Fremont, CA 94538 | 2019-02-07 |
| 1902370067 | Nicole Sandoval | Counselor | 39155 Liberty St Suite E500, Fremont, CA 94538 | 2019-01-11 |
| 1497225015 | Megan Galban | Behavior Technician | 39210 State St. Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1780154302 | Karla Patricia Plascencia | Behavior Technician | 39210 State Street Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1215407846 | Sydney J Torrens | Behavior Technician | 39210 State St. Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2018-11-27 |
| 1932676277 | Jarah Harvan | Psychologist | 1999 Mowry Ave Ste F, Fremont, CA 94538 | 2018-10-24 |
| 1205321965 | Chien Shien Yang Md Inc | Psychiatry & Neurology | 1860 Mowry Ave Ste 301a, Fremont, CA 94538 | 2018-06-26 |
| 1912416199 | Advanced Interventional Surgical Center | Clinic/Center | 3077 Stevenson Blvd, Fremont, CA 94538 | 2017-09-20 |
| Find all providers in zip 94538 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225583230 | Peggy Smith | Specialist | 309 Garrison St, Fremont, OH 43420-3031 | 2016-08-19 |
| 1669837894 | Vijayanand Pawar | Specialist | 41238 Roberts Ave, Apt 5, Fremont, CA 94538-4937 | 2015-12-14 |
| 1871864090 | Cheryl Lee Kublin | Specialist | 4554 W. 48th St, Fremont, MI 49412 | 2012-01-19 |
| 1255655213 | Brandy Chipman | Specialist | 140 Lane 587aa Lake James, Fremont, IN 46737-9001 | 2010-03-19 |
| 1396973426 | Aveda Integrative Medical Center Inc | Specialist | 4077 Peralta Blvd, Fremont, CA 94536-4849 | 2009-06-26 |
| 1912142498 | Nancy Kay Corey | Specialist | 40849 Fremont Blvd, Fremont, CA 94538-4306 | 2008-12-11 |
| 1922208354 | Anesthesia Professional, PC | Specialist | 708 E 22nd St, Fremont, NE 68025-2657 | 2007-07-24 |
| 1891917316 | Laurie Ann Jirovsky | Specialist | 1915 E 8th St, Fremont, NE 68025-7006 | 2007-05-03 |
| 1437379765 | Deccan Pacific Medical Group | Specialist | 1860 Mowry Ave Ste 400, Fremont, CA 94538-1730 | 2007-04-27 |
| 1720205362 | Tri Valley Neurosurgical Medical Group | Specialist | 39039 Paseo Padre Pkwy, Suite # 207, Fremont, CA 94538-1620 | 2007-04-18 |
| Find all providers in FREMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.