| Prairie Medical Group | |
|
8540 S Sepulveda Blvd Los Angeles CA 90045-3807 | |
| (310) 214-8677 | |
| Not Available |
| Full Name | Prairie Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 8540 S Sepulveda Blvd, Los Angeles, California |
| Authorized Official Name and Position | Christopher Chidi (OWNER PRESIDENT) |
| Authorized Official Contact | 3102148677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Medical Group 8540 S Sepulveda Blvd Los Angeles CA 90045-3807 Ph: (310) 214-8677 | Prairie Medical Group 8540 S Sepulveda Blvd Los Angeles CA 90045-3807 Ph: (310) 214-8677 |
| NPI Number | 1538332960 |
|---|---|
| Provider Enumeration Date | 04/07/2008 |
| Last Update Date | 04/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538332960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A53294 (California) | Primary |
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