Medlink Prestige Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEDLINK PRESTIGE GROUP INC

Practice address

8730 Glenoaks Blvd # 4
Sun Valley, CA 91352-2801

Phone

(818) 960-7171

Fax

(818) 960-7177

NPI assigned

Nov 18, 2019

Organization subpart

No

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

Authorized official

Name

Maria E Fernandez, PA

Title

President

Phone

(818) 960-7171

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1316583057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8730 GLENOAKS BLVD # 4",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913522801",
            "telephone_number": "818-960-7171",
            "fax_number": "818-960-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8730 GLENOAKS BLVD # 4",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913522801",
            "telephone_number": "818-960-7171",
            "fax_number": "818-960-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINK PRESTIGE GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-960-7171",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.