Prairie Medical Group Inc

LBN: Prairie Medical Group Inc
Prairie Medical Group Inc is an health care organization with primary practice located at 2825 Santa Monica Blvd Suite 301, Santa Monica CA 90404. 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) 082-9313, or through Chidi, Christopher C via phone (310) 214-8677.

Contact Information

Primary practice address
2825 Santa Monica Blvd Suite 301 Santa Monica CA 90404
Phone: (310) 082-9313
Fax: (310) 828-9156
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 119553 California

Profile Details

NPI number 1386790145
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 26th, 2007
Last updated Aug 22nd, 2020 - about 6 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 1386790145 NPPES
California MEDICAID GR0078674

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