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General NPI Number Information
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NPI Number | 1801466396
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Entity Type | Organization
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Legal Business Name | PRIVILEGE MEDICAL, INC.
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 1950 E 20TH ST # E523
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City | CHICO
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State | CA
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Zip | 95928-6369
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Country | US
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Telephone | 714-720-9162
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Fax |
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Provider Business Mailing Address
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Address Line | 660 ROYCE LN
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City | CHICO
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State | CA
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Zip | 95973-8703
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Country | US
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Telephone | 732-322-3260
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MARIA NERISSA PRIETO
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Credential | MD
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Telephone | 732-322-3260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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