PLEASANTON FAMILY MEDICAL CENTER, INC. (NPI# 1114980612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114980612 |
| Entity Type | Organization |
| Organization Name | PLEASANTON FAMILY MEDICAL CENTER, INC. |
| Practice Address |
11030 Bollinger Canyon Rd # 240 San Ramon CA 94582-4874 |
| Practice Telephone | 9257362200 |
| Practice Fax Number | 9257366100 |
| Mailing Telephone | 9257362200 |
| Mailing Fax Number | 9257366100 |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2013-06-28 |
| Authorized Official Name | DR. ALFRED E TAN (CEO) |
| Authorized Official Telephone | 9257362200 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | G48933 | CA | Ambulatory Health Care Facilities |
| Street Address |
11030 BOLLINGER CANYON RD # 240 |
| City | SAN RAMON |
| State | CA |
| Zip Code | 94582-4874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295110682 | John Muir Physician Network | Family Medicine | 11030 Bollinger Canyon Rd, Suite 200, San Ramon, CA 94582-4874 | 2015-07-27 |
| 1477968741 | Prestige Med Inc | Internal Medicine | 11030 Bollinger Canyon Rd, Suite 240, San Ramon, CA 94582-4874 | 2014-06-25 |
| 1447510789 | Prestige Med Inc | Hospitalist | 11030 Bollinger Canyon Rd, Ste 240, San Ramon, CA 94582-4874 | 2012-05-21 |
| 1851583884 | Jennifer L Grabenstetter | Obstetrics & Gynecology | 11030 Bollinger Canyon Rd, Suite 250, San Ramon, CA 94582 | 2007-08-14 |
| 1629132857 | Joanne Vogel Md Inc | Obstetrics & Gynecology | 11030 Bollinger Canyon Rd, Suite 250, San Ramon, CA 94582-4874 | 2006-12-21 |
| 1457447898 | Erik Michael Gracer | Family Medicine | 11030 Bollinger Canyon Rd, Ste 200, San Ramon, CA 94582-4874 | 2006-10-05 |
| 1043220031 | Joseph Yusaf Mardanzai | Internal Medicine | 11030 Bollinger Canyon Rd, Ste 240, San Ramon, CA 94582-4874 | 2006-08-09 |
| 1396794509 | Joanne R. Vogel | Obstetrics & Gynecology | 11030 Bollinger Canyon Rd, Suite 250, San Ramon, CA 94582-4874 | 2006-05-08 |
| 1962465955 | Alfred Euaik Tan | Family Medicine | 11030 Bollinger Canyon Rd, Suite240, San Ramon, CA 94582-4874 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184252710 | John Paul Yap | Student in an Organized Health Care Education/Training Program | 741 Roseum Ct, San Ramon, CA 94582 | 2020-03-30 |
| 1740762103 | Gilan Mansour | Pharmacist | 7108 Watsonia Dr, San Ramon, CA 94582 | 2018-09-03 |
| 1235635624 | Justin Michael Chan | Pharmacist | 11440 Windemere Parkway, San Ramon, CA 94582 | 2018-04-04 |
| 1033643317 | Ebony Shaunte Berry | Behavior Technician | 3201 Crestfield Dr, San Ramon, CA 94582 | 2017-04-13 |
| 1558729202 | Hoa Trang | Pharmacist | 2053 Poinsettia Street, San Ramon, CA 94582 | 2016-02-09 |
| 1922364652 | Aruna Somani | Internal Medicine | 6400 Main Branch Road, San Ramon, CA 94582 | 2012-04-06 |
| 1790061364 | Darren Dong-shung Gae | Pharmacist | 11440 Windemere Pkwy, San Ramon, CA 94582 | 2011-10-27 |
| 1134457112 | Azmeena Amir Hashem | Nurse Practitioner | 3085 Lakemont Dr Unit 3, San Ramon, CA 94582 | 2009-12-02 |
| 1619985892 | Rashpal S. Deol | Dentist | 500 Bollinger Canyon Way Ste 8.5, San Ramon, CA 94582 | 2006-08-04 |
| 1851811822 | Revelcare LLC | Technician, Pathology | 11040 Bollinger Canyon Rd, Ste 839, San Ramon, CA 94582 | 2017-06-21 |
| Find all providers in zip 94582 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1497046320 | Splendor Management Corp | Clinic/Center | 9260 Alcosta Blvd, Building C-17, San Ramon, CA 94583-4134 | 2011-04-26 |
| 1013055722 | Tri-valley Endocrinology A Professional Corporation | Clinic/Center | 5401 Norris Canyon Rd, Suite 108, San Ramon, CA 94583-5409 | 2007-02-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.