Provider Demographics
NPI:1407418346
Name:SUNOL HILLS AT FREMONT
Entity type:Organization
Organization Name:SUNOL HILLS AT FREMONT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARMOHINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:ATHWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-651-5808
Mailing Address - Street 1:5149 WINSTON CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-6523
Mailing Address - Country:US
Mailing Address - Phone:510-494-1567
Mailing Address - Fax:
Practice Address - Street 1:5149 WINSTON CT
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-6523
Practice Address - Country:US
Practice Address - Phone:510-792-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNOL HILLS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-01
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health