NPI Code Details Logo

NPI 1730077728

NPI 1730077728 : PROMPT MEDICAL SERVICE INC : UPLAND, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1730077728
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    PROMPT MEDICAL SERVICE INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/26/2025
-----------------------------------------------------
    Last Update Date     |    11/13/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    222 N MOUNTAIN AVE STE 205 
-----------------------------------------------------
    City                 |    UPLAND
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    91786-5714
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    716-301-2036
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    222 N MOUNTAIN AVE STE 205 
-----------------------------------------------------
    City                 |    UPLAND
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    91786-5714
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    716-301-2036
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OFFICE MANAGER
-----------------------------------------------------
    Name                 |    MR. SAM  JEFFERY 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    716-301-2036
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    207Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Family Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.