Organization
FREMONT NEUROLOGY MEDICAL ASSOCIATES INC A PROF MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRABHJOT SINGH KHALSA M.D. (PRESIDENT)
(510) 713-3390
Entity
Organization
Contact information
Practice address
722 MOWRY AVE, FREMONT, CA 94536-4115
(510) 713-3390
(510) 713-3393
Mailing address
722 MOWRY AVE, FREMONT, CA 94536-4115
(510) 713-3390
(510) 713-3393
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G66263
CA
2084N0600X
Clinical Neurophysiology Physician
G66263
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G662631
—
CA
Enumeration date
03/27/2006
Last updated
12/11/2007
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