Healthcare Provider Details

I. General information

NPI: 1053237891
Provider Name (Legal Business Name): PRESTIGE MEDICAL CLINIC AND URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2219 S MOUNTAIN AVE
ONTARIO CA
91762-6133
US

IV. Provider business mailing address

1984 INDIAN HILL BLVD
POMONA CA
91767-3620
US

V. Phone/Fax

Practice location:
  • Phone: 833-755-2273
  • Fax:
Mailing address:
  • Phone: 909-447-2323
  • Fax: 909-447-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EMY ODURO-BURTON
Title or Position: CEO
Credential: DNP
Phone: 909-447-2323