Organization Active NPI

Prestige Medical Clinic and Urgent Care Inc

  • Urgent Care Clinic/Center
  • Rancho Cucamonga, CA
National Provider Identifier
1396683801
Registry record updated Jul 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PRESTIGE MEDICAL CLINIC AND URGENT CARE INC
Practice address
12709 Foothill Blvd
Rancho Cucamonga, CA 91739-9761
Phone
(909) 377-1800
Fax
(909) 377-0200
NPI assigned
Mar 24, 2026
Last updated
Jul 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2026

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

Authorized official

Name
Emy Oduro-Burton, DNP-BCNPI 1205210531
Title
President
Phone
(909) 447-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU
Primary Care Clinic/Center 261QP2300X NU
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

12709 Foothill Blvd
Rancho Cucamonga, CA 91739-9761

Mailing address

12709 Foothill Blvd
Rancho Cucamonga, CA 91739-9761
Phone (909) 377-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191226000750 CA Part B Supplier - Clinic/Group Practice 0840624953 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pomona, CA; Rancho Cucamonga, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Prestige Medical Clinic and Urgent Care Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783728000000",
    "number": "1396683801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12709 FOOTHILL BLVD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399761",
            "telephone_number": "909-377-1800",
            "fax_number": "909-377-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12709 FOOTHILL BLVD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399761",
            "telephone_number": "909-377-1800",
            "fax_number": "909-377-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE MEDICAL CLINIC AND URGENT CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A",
        "authorized_official_last_name": "ODURO-BURTON",
        "authorized_official_first_name": "EMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-447-1800",
        "authorized_official_credential": "DNP-BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2026; 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.