PRAIRIE MEDICAL GROUP INC NPI 1407902240

NPI Information

  • NPI: 1407902240
  • Provider Name: PRAIRIE MEDICAL GROUP INC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 323 N. PRAIRIE AVE
    SUITE 460
    INGLEWOOD, CA
    ZIP 90301
  • Phone: (310) 674-9010

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NPI Details

PRAIRIE MEDICAL GROUP INC is a specialist in Inglewood, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PRAIRIE MEDICAL GROUP INC NPI is 1407902240. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

323 N. PRAIRIE AVE
SUITE 460
INGLEWOOD, CA
ZIP 90301
Phone: (310) 674-9010
Fax: (310) 677-5072

The provider's authorized official is Christopher C Chidi .
The authorized official title is President and has the following contact phone number (310) 214-8677.

The enumeration date for this NPI number is 1/26/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist05529709CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GR0078671MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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