Westside Premier Med GRP

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC27666 Issued in CA

Legal business name

WESTSIDE PREMIER MED GRP

Practice address

17330 Bear Valley Rd Ste 105
Victorville, CA 92395

Phone

(760) 245-8182

Fax

(760) 245-2123

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Kim Ammerman

Title

Administrator

Phone

(760) 949-1489

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1376680124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17330 BEAR VALLEY RD STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-245-8182",
            "fax_number": "760-245-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17330 BEAR VALLEY RD STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-245-8182",
            "fax_number": "760-245-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE PREMIER MED GRP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "AMMERMAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "760-949-1489"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC21523",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27666",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A36514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Victorville, CA
• Providers in Victorville, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.