Organization Active NPI

Lifeline Medical Group Inc

  • Primary Care Clinic/Center
  • Palmdale, CA
National Provider Identifier
1265313456
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LIFELINE MEDICAL GROUP INC
Practice address
2270 E Palmdale Blvd Ste F
Palmdale, CA 93550-1334
Phone
(661) 386-8983
Fax
(661) 386-8985
NPI assigned
Sep 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Vincent Estacio, RN
Title
Partner
Phone
(661) 673-3204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2270 E Palmdale Blvd Ste F
Palmdale, CA 93550-1334

Mailing address

2270 E Palmdale Blvd Ste F
Palmdale, CA 93550-1334
Phone (661) 386-8983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260218003973 CA Part B Supplier - Clinic/Group Practice 7113407016 Receives reassigned benefits from 1 practitioner
Practice locations: Palmdale, CA

National Provider Directory

National Provider Directory

Locations

2270 E Palmdale Blvd
Palmdale, CA 93550
Phone (661) 947-5600

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1265313456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 E PALMDALE BLVD STE F",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935501334",
            "telephone_number": "661-386-8983",
            "fax_number": "661-386-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 E PALMDALE BLVD STE F",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935501334",
            "telephone_number": "661-386-8983",
            "fax_number": "661-386-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "ESTACIO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "661-673-3204",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.