Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Annisa Nabila Soeboer, PA-C

Individual provider Physician Assistant · NPI 1053985929

Annisa Nabila Soeboer, PA-C is a Physician Assistant in Fremont, California. Graduated from Touro Un College of Osteopathic Medicine, Vallejo in 2022, 4 years ago. Practices with City Medical of Upper East Side PLLC, a 663-clinician group and accepts Medicare assignment.

Years since qualifying
4
Trained at
Touro Un College of Osteopathic Medicine, Vallejo
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2000 Mowry Ave
Fremont, CA 94538-1716
Phone: (707) 771-5687
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1053985929
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 16, 2021
Last updated in NPPESMarch 7, 2023
Certification dateSeptember 30, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolTOURO UN COLLEGE OF OSTEOPATHIC MEDICINE, VALLEJO
Graduated 2022 (4 years in practice)
Group practice City Medical Of Upper East Side Pllc — 663 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in Fremont