Pleasanton Family Medical Center, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

G48933 Issued in CA

Legal business name

PLEASANTON FAMILY MEDICAL CENTER, INC.

Practice address

11030 Bollinger Canyon Rd
# 240
San Ramon, CA 94582-4874

Phone

(925) 736-2200

Fax

(925) 736-6100

NPI assigned

Apr 7, 2006

Last updated

Jun 28, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alfred E Tan, M.D.NPI 1962465955

Title

Ceo

Phone

(925) 736-2200

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alfred Euaik Tan, M.D.

  • Family Medicine Physician
  • San Ramon, CA
  • NPI 1962465955
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1114980612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11030 BOLLINGER CANYON RD",
            "address_2": "# 240",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945824874",
            "telephone_number": "925-736-2200",
            "fax_number": "925-736-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11030 BOLLINGER CANYON RD",
            "address_2": "# 240",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945824874",
            "telephone_number": "925-736-2200",
            "fax_number": "925-736-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANTON FAMILY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-736-2200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "G48933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pleasanton Diagnostic Imaging, Inc.
• Jennifer Polite
• Mary Kay Polsemen, D.C.
• Alexis Pommier Tu, PPS
• Linda Pon, ATC
• Pontine Incorporated

• Clinic/Center in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.