Prairie Medical Group Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PRAIRIE MEDICAL GROUP INC

Practice address

Department No 2834
Los Angeles, CA 90084-2826

Phone

(310) 214-8677

Fax

(310) 921-1718

NPI assigned

Jan 23, 2007

Last updated

Jul 21, 2022By 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. Christopher C Chidi, MD

Title

President

Phone

(310) 214-8677

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1356495626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT NO 2834",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900842826",
            "telephone_number": "310-214-8677",
            "fax_number": "310-921-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT NO 2834",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900842826",
            "telephone_number": "310-214-8677",
            "fax_number": "310-921-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CHIDI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-214-8677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078673",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078675",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078671",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0078674",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Henry Alan Praetzel, PSYD, LP
• Allen B Prager, DPM
• Beril Prager, LCSW
• Joshua P. Prager, M.D.
• Prairie Medical Group
• Divya Pravinchand Prajapati, MD
• Suneet Pramanik, MD
• Sydney Pranitis, PSY.D.
• Thunyavadee Prapin
• Alexandra E Prappas, MA, BCBA

• Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.