Provider Demographics
NPI:1730077728
Name:PROMPT MEDICAL SERVICE
Entity type:Organization
Organization Name:PROMPT MEDICAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-301-2036
Mailing Address - Street 1:505 N TUSTIN AVE STE 190
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3777
Mailing Address - Country:US
Mailing Address - Phone:716-301-2036
Mailing Address - Fax:
Practice Address - Street 1:505 N TUSTIN AVE STE 190
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3777
Practice Address - Country:US
Practice Address - Phone:716-301-2036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center