Active NPI
Fremont Medical Group, Inc.
- Gastroenterology Physician
- Fremont, CA
National Provider Identifier
1528009396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- G66303
- Legal business name
- FREMONT MEDICAL GROUP, INC.
- Practice address
- 734 Mowry Ave
Fremont, CA 94536-4115 - Phone
- (510) 793-3033
- Fax
- (510) 793-4952
- NPI assigned
- Jun 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Janis Shikano
- Title
- Office Manager
- Phone
- (510) 793-3033
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G4628 | CA | |
| Internal Medicine Physician | 207R00000X | G6855 | CA | |
| Cardiovascular Disease Physician | 207RC0000X | A44320 | CA | |
| Gastroenterology Physician | 207RG0100X | G66303 | CA | Primary |
| Rheumatology Physician | 207RR0500X | A53697 | CA |
Addresses
Primary practice location
734 Mowry Ave
Fremont, CA 94536-4115
Mailing address
734 Mowry Ave
Fremont, CA 94536-4115
Phone (510) 793-3033
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0077610 | Medicaid | CA | |
| ZZZ46056Z | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081112000392 | CA | Part B Supplier - Clinic/Group Practice | 8820157340 |
Receives reassigned benefits from 1 practitioner Practice locations: Fremont, CA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1528009396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "734 MOWRY AVE",
"city": "FREMONT",
"state": "CA",
"postal_code": "945364115",
"telephone_number": "510-793-3033",
"fax_number": "510-793-4952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "734 MOWRY AVE",
"city": "FREMONT",
"state": "CA",
"postal_code": "945364115",
"telephone_number": "510-793-3033",
"fax_number": "510-793-4952"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FREMONT MEDICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-10",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "SHIKANO",
"authorized_official_first_name": "JANIS",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "510-793-3033"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "CA",
"license": "G4628",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "CA",
"license": "G6855",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CA",
"license": "A44320",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G66303",
"primary": true
},
{
"code": "207RR0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Rheumatology",
"state": "CA",
"license": "A53697",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0077610",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ46056Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fremont, CA
- Fremont Eat Nose & Throat Med Group Inc
- Fremont Family & Sports Chiropractic
- Fremont Healthcare Operating Company, LP
- Fremont Hearing Aid Center
- Fremont Internal Medicine Medical Associates,Inc
- Fremont Nephrology Prof Corp
- Fremont Neurology Medical Associates Inc a Prof Medical Corp
- Fremont Optometric Group
- Fremont Optometric Vision Care Center
- Fremont Oral & Maxillofacial Surgery
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.