Provider Demographics
NPI:1225455413
Name:CITY OF FREMONT
Entity type:Organization
Organization Name:CITY OF FREMONT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KWAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-574-2007
Mailing Address - Street 1:39155 LIBERTY ST. SUITE A110
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94537-5006
Mailing Address - Country:US
Mailing Address - Phone:510-574-2000
Mailing Address - Fax:510-574-2001
Practice Address - Street 1:39155 LIBERTY ST SUITE A110
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1513
Practice Address - Country:US
Practice Address - Phone:510-574-2000
Practice Address - Fax:510-574-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health