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CIVIC MEDICAL CENTER, INC.
NPI 1629482757
Internal Medicine in Fremont, CA

Active since June 17, 2014CLIA 05D0991615 · Waiver
2147 MOWRY AVE, SUITE D4, FREMONT, CA 94538(510) 574-0800(510) 574-0850 Get Directions Write a Review

NPPES record last updated: September 29, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Civic Medical Center, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CIVIC MEDICAL CENTER, INC. (NPI 1629482757) is a healthcare organization registered as an internal medicine in Fremont, California and active in the NPI registry since June 2014. The organization holds a CLIA Waiver certificate valid through May 18, 2028 and lists Namrata Mehta, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1629482757
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCIVIC MEDICAL CENTER, INC.
Location Address2147 MOWRY AVE, SUITE D4Fremont, CA 94538-1724
Mailing Address2147 Mowry Ave, Suite D4Fremont, CA 94538-1724 · (510) 574-0800 · Fax (510) 574-0850
Phone(510) 574-0800
Fax(510) 574-0850
Organization SubpartNo
Authorized OfficialNamrata MehtaOffice Manager · (510) 574-0800
Enumeration DateJune 17, 2014
Last NPPES UpdateSeptember 29, 2014
✔ NPI 1629482757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2147 MOWRY AVE, Fremont, CA 94538
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Other Identifiers 2

Medicare UPINH79963CA
Medicare UPING82583CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0991615

Civic Medical Center, Inc · Fremont, CA
Active · expires May 18, 2028
CLIA Number05D0991615
Laboratory TypePhysician Office
Certificate Effective DateMay 19, 2026
Certificate Expiration DateMay 18, 2028
Laboratory DirectorBala Annadurai, MD
Laboratory Phone(510) 574-0800
Laboratory LocationCivic Medical Center, Inc2147 Mowry Ave Ste D4, Fremont, CA 94538
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RONGYUAN ZHAO
Acupuncturist
2147 MOWRY AVE, SUITE #A-4
FREMONT, CA 94538
Alameda County (510) 796-0188
BALA P ANNADURAI M.D.
Internal Medicine
2147 MOWRY AVE, SUITE D4
FREMONT, CA 94538
Alameda County (510) 574-0800
CHRISTOPHER MAH
Podiatrist
2147 MOWRY AVE, SUITE D-2
FREMONT, CA 94538
Alameda County (510) 793-1583
PINGPING LI L.AC.
Acupuncturist
2147 MOWRY AVE, SUITE A4
FREMONT, CA 94538
Alameda County (408) 676-7917
YIH CHANG M.D.
Internal Medicine
2147 MOWRY AVE, STE D3
FREMONT, CA 94538
Alameda County (510) 648-2087
WENYING ZHU LAC
Acupuncturist
2147 MOWRY AVE, SUITE A4
FREMONT, CA 94538
Alameda County (510) 494-9788
RHODORA C. DELA CRUZ M.D.
Pediatrics
2147 MOWRY AVE, SUITE A2
FREMONT, CA 94538
Alameda County (510) 793-1030
DR. BENJAMIN JASON CHEW D.D.S.
Dentist (General Practice)
2147 MOWRY AVE, SUITE B2
FREMONT, CA 94538
Alameda County (510) 745-9299

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Civic Medical Center, Inc.'s NPI number?

The NPI number for Civic Medical Center, Inc. is 1629482757. It was assigned to this organization in the NPPES registry on June 17, 2014.

Where is Civic Medical Center, Inc. located?

Civic Medical Center, Inc. is located at 2147 Mowry Ave Suite D4, Fremont, CA 94538. The listed phone number is (510) 574-0800.

What is Civic Medical Center, Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Civic Medical Center, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0991615) is associated with this NPI, valid through May 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Civic Medical Center, Inc. was last updated on September 29, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.