Healthcare Provider Details

I. General information

NPI: 1679483010
Provider Name (Legal Business Name): PRIME ORBBIT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 W BARSTOW AVE APT 109
FRESNO CA
93711-6671
US

IV. Provider business mailing address

3625 W BARSTOW AVE APT 109
FRESNO CA
93711-6671
US

V. Phone/Fax

Practice location:
  • Phone: 253-419-0948
  • Fax:
Mailing address:
  • Phone: 253-419-0948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. NO GIVEN NAME SUSHIL
Title or Position: OWNER
Credential:
Phone: 253-419-0948