Provider Demographics
NPI:1316027527
Name:PLEASANT CARE MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:PLEASANT CARE MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:D
Authorized Official - Last Name:COITE-AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-582-4700
Mailing Address - Street 1:5601 NORRIS CANYON RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-5407
Mailing Address - Country:US
Mailing Address - Phone:925-830-0644
Mailing Address - Fax:925-830-0868
Practice Address - Street 1:5601 NORRIS CANYON RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5407
Practice Address - Country:US
Practice Address - Phone:925-830-0644
Practice Address - Fax:925-830-0868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG044402207Q00000X
CAG20961207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41116Medicare UPIN
CAA49367Medicare UPIN