Organization
WASHINGTON TOWNSHIP HOSPITAL DEVELOPMENT CORPORATION
Active
Other names
Washington Outpatient Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY FARBER (PRESIDENT AND CEO)
(510) 745-6500
Entity
Organization
Contact information
Practice address
39141 CIVIC CENTER DR, SUITE 120, FREMONT, CA 94538-5818
(510) 794-9672
(510) 792-8138
Mailing address
39141 CIVIC CENTER DR, SUITE 120, FREMONT, CA 94538-5818
(510) 794-9672
(510) 792-8138
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
OT8813
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GCT000660
—
CA
01
—
ZZZ34510Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
11/11/2008
Last updated
08/24/2009
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