Prime ENT Sinus Sleep & Allergy Inc

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

PRIME ENT SINUS SLEEP & ALLERGY INC

Practice address

1503 E March LN Ste a
Stockton, CA 95210-5622

Phone

(209) 315-0400

Fax

(209) 314-6455

NPI assigned

Oct 27, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shilpa S Malik, MDNPI 1316280142

Title

Owner

Phone

(614) 595-2033

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shilpa Sindhu Malik, M.D.

  • Otolaryngology Physician
  • Stockton, CA
  • NPI 1316280142
  Medicare reassignment NPD Authorized official
• Jasbir Singh Gill

  • Obstetrics & Gynecology Physician
  • Stockton, CA
  • NPI 1538681432
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1154048395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952411450",
            "telephone_number": "209-315-0400",
            "fax_number": "209-314-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 E MARCH LN STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952105622",
            "telephone_number": "209-315-0400",
            "fax_number": "209-314-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME ENT SINUS SLEEP & ALLERGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "SHILPA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-595-2033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Prima, O.D.
• Daren Stephen Primack, MD
• Robyn Primack, RD
• Todd Primack, D.O.
• Prime Care Medical Supplies LLC
• Eileen P Primero, MD
• Sylvia Primous
• Kaitlyn Nicole Privett
• Maleah Prodigalidad
• Professional Medical Laboratory Services

• Otolaryngology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.