Medline Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A34211 Issued in CA

Legal business name

MEDLINE MEDICAL CENTER

Practice address

3742 N 1St St
Fresno, CA 93726-5601

Phone

(559) 307-5990

Fax

(559) 420-0369

NPI assigned

Sep 20, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Sudhir Bagga, MD

Title

Ceo

Phone

(559) 307-5990

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1508174889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3742 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937265601",
            "telephone_number": "559-307-5990",
            "fax_number": "559-420-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3742 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937265601",
            "telephone_number": "559-307-5990",
            "fax_number": "559-420-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "BAGGA",
        "authorized_official_first_name": "SUDHIR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-307-5990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A34211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Bibanco Medina
• Sabino Medina Jr.
• Sabino Orland Medina III, DPT
• Sandra Elaine Medina, MS
• Mediva LLC
• Aubree Medlock
• Laurel J Medlock
• Medmark Treatment Center Fresno
• Medmark Treatment Centers - Fresno West, Inc.
• Medmark Treatment Centers-Fresno East, Inc.

• Family Medicine Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.