Prospera Group Corp

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PROSPERA GROUP CORP

Practice address

3831 Hughes Ave
Suite 602
Culver City, CA 90232-2751

Phone

(310) 204-6897

Fax

(310) 204-4690

NPI assigned

Nov 1, 2006

Last updated

Sep 26, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Rena Keynigshteyn, MDNPI 1316980535

Title

President

Phone

(310) 204-6897

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rena Keynigshteyn, M.D.

  • General Practice Physician
  • Culver City, CA
  • NPI 1316980535
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1285711937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE",
            "address_2": "SUITE 602",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322751",
            "telephone_number": "310-204-6897",
            "fax_number": "310-204-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE",
            "address_2": "SUITE 602",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322751",
            "telephone_number": "310-204-6897",
            "fax_number": "310-204-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERA GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "KEYNIGSHTEYN",
        "authorized_official_first_name": "RENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-204-6897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "1285711937",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285711937",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Bailey Profio, AMFT
• Progressive Medical Imaging, Inc.
• Progressus Therapy, LLC
• Project by Project
• Roshawn Steven Propps
• Prosperity Home Health Services Inc.
• Prosthetic & Orthotic Group Los Angeles, Inc
• Psychemedics Corporation
• PT Medical, Inc
• Bianca Lydia Pulido

• Multi-Specialty Clinic/Center in Culver City, CA
• Providers in Culver City, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.