| Union City | |
|
1203 J St Union City CA 94587-3331 | |
| (510) 489-5200 | |
| Not Available |
| Full Name | Union City |
|---|---|
| Speciality | Dentist |
| Location | 1203 J St, Union City, California |
| Authorized Official Name and Position | Ed Pegueros (ASST DEAN, BUDGET & FIN ADMIN) |
| Authorized Official Contact | 4153517192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Union City 1203 J St Union City CA 94587-3331 Ph: (510) 489-5200 | Union City 1203 J St Union City CA 94587-3331 Ph: (510) 489-5200 |
| NPI Number | 1699802215 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 01/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699802215 | NPI | - | NPPES |
| G01001-06 | Other | CA | DENTI-CAL IDENTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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