Organization Active NPI

John Heine M.D. & Mark Avon M.D. PTRS

  • Specialist
  • Fremont, CA
National Provider Identifier
1568675700
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A24518 Issued in CA
Legal business name
JOHN HEINE M.D. & MARK AVON M.D. PTRS
Practice address
1999 Mowry Ave Ste 2M
Fremont, CA 94538-1706
Phone
(510) 793-3505
Fax
(510) 793-4799
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John P Heine, M.D.
Title
Partner
Phone
(510) 793-3505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A24518 CA Primary

Addresses

Primary practice location

1999 Mowry Ave Ste 2M
Fremont, CA 94538-1706

Mailing address

1999 Mowry Ave Ste 2M
Fremont, CA 94538-1706
Phone (510) 793-3505

National Provider Directory

National Provider Directory

Locations

1999 Mowry Ave
Ste 2M
Fremont, CA 94538
Phone (510) 793-3505

Practitioners & 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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1568675700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 MOWRY AVE STE 2M",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381706",
            "telephone_number": "510-793-3505",
            "fax_number": "510-793-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 MOWRY AVE STE 2M",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381706",
            "telephone_number": "510-793-3505",
            "fax_number": "510-793-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN HEINE M.D. & MARK AVON M.D. PTRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "510-793-3505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A24518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.