Active NPI
Med-Line Medical Group
- Psychiatry Physician
- Loma Linda, CA
National Provider Identifier
1538058359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- MED-LINE MEDICAL GROUP
- Doing business as
- MED-LINE
- Practice address
- 11387 Poplar Street
Loma Linda, CA 92354 - Phone
- (617) 299-6398
- NPI assigned
- Jun 30, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- N Agrawal
- Title
- Manager
- Phone
- (617) 299-6398
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Health & Wellness Coach | 171400000X | |||
| Naturopath | 175F00000X | |||
| Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | 2081P0301X | |||
| Clinical Informatics Physician | 2083C0008X | |||
| Psychiatry Physician | 2084P0800X | Primary | ||
| Child & Adolescent Psychiatry Physician | 2084P0804X | |||
| Sports Medicine (Psychiatry & Neurology) Physician | 2084S0010X | |||
| Sleep Medicine (Psychiatry & Neurology) Physician | 2084S0012X | |||
| General Practice Physician | 208D00000X | |||
| Laboratory Management Specialist/Technologist | 246QL0900X | |||
| EEG Specialist/Technologist | 246ZE0500X | |||
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | |||
| Research Clinic/Center | 261QR1100X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X |
Addresses
Primary practice location
11387 Poplar Street
Loma Linda, CA 92354
Mailing address
PO Box 904
Redlands, CA 92373
Other names 1
- MED-LINE
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- San Diego, CA
- NPI 1023376936
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751241600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1751241600000",
"number": "1538058359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 904",
"city": "REDLANDS",
"state": "CA",
"postal_code": "92373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11387 POPLAR STREET",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "92354",
"telephone_number": "617-299-6398"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MED-LINE MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2025-06-30",
"last_updated": "2025-06-30",
"certification_date": "2025-06-29",
"status": "A",
"authorized_official_last_name": "AGRAWAL",
"authorized_official_first_name": "N",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "617-299-6398"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": false
},
{
"code": "175F00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Naturopath",
"state": null,
"license": null,
"primary": false
},
{
"code": "2081P0301X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2083C0008X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Preventive Medicine, Clinical Informatics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084S0010X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Sports Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084S0012X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Sleep Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
},
{
"code": "246QL0900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Pathology, Laboratory Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZE0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, EEG",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZE0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR1100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Research",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MED-LINE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.