PALO ALTO MEDICAL FOUNDATION/FREMONT CENTER NPI 1316982994

Durable Medical Equipment & Medical Supplies in Fremont, CA

NPI 1316982994 Organization Durable Medical Equipment & Medical Supp... CLIA Number 05D0598778 CLIA Certificate of Compliance

About PALO ALTO MEDICAL FOUNDATION/FREMONT CENTER

Palo Alto Medical Foundation/fremont Center is a provider established in Fremont, California specializing in durable medical equipment & medical supplies. The NPI number of Palo Alto Medical Foundation/fremont Center is 1316982994 and was assigned on June 2006. The practitioner's primary taxonomy code is 332B00000X with license number 0262640001 (CA). The provider is registered as an organization and their NPI record was last updated 9 years ago. The authorized official of this NPI record is Richard Slavin M.d. (Ceo)

The CLIA number of Palo Alto Medical Foundation/fremont Center is 05D0598778 registered as a "community clinic" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued to Palo Alto Medical Foundation/fremont Center after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

NPI

1316982994

Provider NamePALO ALTO MEDICAL FOUNDATION/FREMONT CENTER
Provider Location Address3200 KEARNEY ST FREMONT, CA 94538
Provider Mailing Address2350 W EL CAMINO REAL 2ND FLOOR MOUNTAIN VIEW, CA 94040
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date06-18-2006
Last Update Date04-30-2012


Primary Taxonomy

Taxonomy Code332B00000X
ClassificationDurable Medical Equipment & Medical Supplies
TypeSuppliers
License No.0262640001
License StateCA
Taxonomy DescriptionA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Business Address

PALO ALTO MEDICAL FOUNDATION/FREMONT CENTER
3200 KEARNEY ST
FREMONT, CA
ZIP 94538
Phone: (510) 490-1222

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Mailing Address

PALO ALTO MEDICAL FOUNDATION/FREMONT CENTER
2350 W EL CAMINO REAL
2ND FLOOR
MOUNTAIN VIEW, CA
ZIP 94040
Phone: (650) 934-3529



Authorized Official

Authorized Official Name RICHARD SLAVIN M.D.
Authorized Official TitleCEO
Authorized Official Phone(650) 934-7221

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1316982994 is:

CLIA Number05D0598778
Facility TypeCOMMUNITY CLINIC
Certificate TypeCertificate of Compliance

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
ZZZ95477ZMEDICARE ID-TYPE UNSPECIFIED (04)CA

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1841286705 KELLY RENEE MILLER MD
Individual
Family Medicine3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1942249933 MANISH SINGHAL MD
Individual
Internal Medicine3200 KEARNEY ST
FREMONT, CA 94538
(209) 603-8524
1053402727 SUE KNOX MD
Individual
Family Medicine3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1902997257 MICHAEL SLESINSKI MD
Individual
Obstetrics & Gynecology3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1902997265 TIMOTHY SCOTT MD
Individual
Ophthalmology3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1245322551 DONNA MCMILLAN MD
Individual
Pediatrics3200 KEARNEY ST
FREMONT, CA 94538
(510) 498-2164
1033201256 TINA FATIN SCOBEL
Individual
Pediatrics3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1598857765 RUPAL BADANI M.D.
Individual
Pediatrics3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1619061033 SUSAN PENG MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1922192103 THUAN DUONG MD
Individual
Family Medicine3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1346335072 RITIKA KAUR AULAKH D.O
Individual
Family Medicine3200 KEARNEY ST
FREMONT, CA 94538
(510) 498-1222
1336238500 MELISSA GIBSON RD
Individual
Dietitian, Registered3200 KEARNEY ST
FREMONT, CA 94538
(209) 603-8524
1265595003 JOCELYN KREISS MD
Individual
Psychiatry & Neurology (Psychiatry)3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1336293422 DEBORAH JANE SPITZ PA
Individual
Nurse Practitioner (Occupational Health)3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1164562112 JULIETA GABIOLA MD
Individual
Internal Medicine3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1588858823 MARISSA LEE MFT
Individual
Marriage & Family Therapist3200 KEARNEY ST
FREMONT, CA 94538
(510) 498-2397
1588846380 SAYALI RANADIVE MD
Individual
Pediatrics3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1740467174 JESSICA ALDAZ FNP
Individual
Nurse Practitioner (Family)3200 KEARNEY ST URGENT CARE CENTER
FREMONT, CA 94538
(510) 490-1222
1215103098 MEESHA PURI NP
Individual
Nurse Practitioner (Family)3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222
1477801587 JOELLE CHRISTIANNE WHALEN PA-C
Individual
Physician Assistant3200 KEARNEY ST
FREMONT, CA 94538
(510) 490-1222

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.