Prairie Medical Group Inc

LBN: Prairie Medical Group Inc
Prairie Medical Group Inc is an health care organization with primary practice located at 10100 Culver Blvd , Culver City CA 90231. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Prairie Medical Group Inc can be contacted via phone (310) 280-2700, or through Chidi, Christopher C via phone (310) 214-8677.

Contact Information

Primary practice address
10100 Culver Blvd Culver City CA 90231
Phone: (310) 280-2700
Fax: (310) 837-7334
Website:
Map and Directions
Authorized official contact:
Name: Chidi, Christopher C Doctor of Medicine (MD)
Phone: (310) 214-8677

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 058963 California

Profile Details

NPI number 1043356272
LBN Legal business name Prairie Medical Group Inc
DBA Doing business as
Authorized official Chidi, Christopher C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 29th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043356272 NPPES
California MEDICAID GR0078673

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