Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Prime Path Medical Group MD

Organization Emergency Medicine Physician · NPI 1396625612

Prime Path Medical Group MD is an Emergency Medicine Physician in Glendale, California. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

1500 S Central Ave Ste 323
Glendale, CA 91204-3858
Phone: (747) 200-6948
Fax: (747) 800-8005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X

Record details

NPI number1396625612
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mason Bragg — Md, Co-Owner, Predident · (747) 800-8005
NPI enumeratedSeptember 5, 2025
Last updated in NPPESSeptember 5, 2025
Certification dateSeptember 5, 2025
Mailing address1500 S Central Ave Ste 323, Glendale, CA 91204-3858

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