| Pleasanton Medical Group | |
|
5924 Stoneridge Dr Ste 103 Pleasanton CA 94588-5400 | |
| (925) 417-7505 | |
| Not Available |
| Full Name | Pleasanton Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 5924 Stoneridge Dr Ste 103, Pleasanton, California |
| Authorized Official Name and Position | Iqbal Inayat Omarali (PRESIDENT) |
| Authorized Official Contact | 9254177505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pleasanton Medical Group 5924 Stoneridge Dr Ste 103 Pleasanton CA 94588-5400 Ph: (925) 417-7505 | Pleasanton Medical Group 5924 Stoneridge Dr Ste 103 Pleasanton CA 94588-5400 Ph: (925) 417-7505 |
| NPI Number | 1174618219 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 11/17/2022 |
| Medicare PECOS PAC ID | 5193976520 |
|---|---|
| Medicare Enrollment ID | O20121113000400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174618219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Secondary |
| Provider Name | Iqbal I Omarali |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588758148 PECOS PAC ID: 2567478803 Enrollment ID: I20060223000851 |
| Provider Name | Tasneem Bader-omarali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578658795 PECOS PAC ID: 1153579206 Enrollment ID: I20121113000440 |
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