Healthcare Provider Details
I. General information
NPI: 1114855020
Provider Name (Legal Business Name): DIVE WELL MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4695 CHABOT DRIVE SUITE 200
PLEASANTON CA
94588
US
IV. Provider business mailing address
2443 FILLMORE ST # 380-8269
SAN FRANCISCO CA
94115-1814
US
V. Phone/Fax
- Phone: 925-482-6118
- Fax:
- Phone: 925-482-6118
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
ALLEN
Title or Position: PRESIDENT
Credential: MD
Phone: 925-482-6118