Healthcare Provider Details

I. General information

NPI: 1902712839
Provider Name (Legal Business Name): MISSION PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3755 BEACON AVE
FREMONT CA
94538-1411
US

IV. Provider business mailing address

3755 BEACON AVE
FREMONT CA
94538-1411
US

V. Phone/Fax

Practice location:
  • Phone: 510-796-7796
  • Fax: 510-796-7797
Mailing address:
  • Phone: 510-796-7796
  • Fax: 510-796-7797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PACITA REYES ADUCAYEN
Title or Position: CEO
Credential: MD
Phone: 925-864-4067