Healthcare Provider Details

I. General information

NPI: 1003768904
Provider Name (Legal Business Name): PLEASANTON URGENT CARE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 DUBLIN BLVD STE 150
DUBLIN CA
94568-3180
US

IV. Provider business mailing address

4000 DUBLIN BLVD STE 150
DUBLIN CA
94568-3180
US

V. Phone/Fax

Practice location:
  • Phone: 877-346-2211
  • Fax: 407-324-4727
Mailing address:
  • Phone: 877-346-2211
  • Fax: 407-324-4727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDWARD KAN
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 877-346-2211