Individual
JEANIE AHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1999 MOWRY AVE, SUITE R, FREMONT, CA 94538-1738
(510) 745-8186
(510) 745-8332
Mailing address
1999 MOWRY AVE, SUITE R, FREMONT, CA 94538-1738
(510) 745-8186
(510) 745-8332
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A65315
CA
207RN0300X
Nephrology Physician
Primary
A065315
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A653150
—
CA
Enumeration date
06/02/2006
Last updated
11/27/2022
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