| Prestige Med Inc | |
|
11030 Bollinger Canyon Rd Ste 240 San Ramon CA 94582-4874 | |
| (925) 718-6622 | |
| (201) 690-8632 |
| Full Name | Prestige Med Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11030 Bollinger Canyon Rd, San Ramon, California |
| Authorized Official Name and Position | Joseph Y Mardanzai (OWNER) |
| Authorized Official Contact | 9257186622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestige Med Inc Po Box 3888 San Ramon CA 94583-8888 Ph: (925) 718-6622 | Prestige Med Inc 11030 Bollinger Canyon Rd Ste 240 San Ramon CA 94582-4874 Ph: (925) 718-6622 |
| NPI Number | 1447510789 |
|---|---|
| Provider Enumeration Date | 05/21/2012 |
| Last Update Date | 11/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447510789 | NPI | - | NPPES |
| GF086A | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A80856 (California) | Primary |
| 208M00000X | Hospitalist | A80856 (California) | Secondary |
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