Premiere Sports Medicine Medical Group

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC29474 Issued in CA

Legal business name

PREMIERE SPORTS MEDICINE MEDICAL GROUP

Practice address

2255 E Maple Ave
El Segundo, CA 90245-6508

Phone

(310) 322-8777

NPI assigned

Dec 16, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Alan Naim, D.C.

Title

President

Phone

(310) 322-8777

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1487075693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 E MAPLE AVE",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902456508",
            "telephone_number": "310-322-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 E MAPLE AVE",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902456508",
            "telephone_number": "310-322-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE SPORTS MEDICINE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "NAIM",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-322-8777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29474",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC32082",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC15268",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G80322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Israel Eugene Prado Jr.
• Magdalena Prado
• Catrina Prather
• Jessica Preciado
• Premiere Spine and Sports Medicine
• Premise Health of California Medical PC
• Angelique Prescott
• Jack Preston
• Louis Preston
• Tea Preston

• Chiropractor in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.