NPIMap

Organization Active NPI

Performance Health Medical Group

  • General Practice Physician
  • Torrance, CA
National Provider Identifier
1922145911
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PERFORMANCE HEALTH MEDICAL GROUP
Practice address
21707 Hawthorne Blvd
Ste 201
Torrance, CA 90503
Phone
(310) 540-9699
Fax
(310) 540-9486
NPI assigned
Jan 31, 2007
Last updated
Apr 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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

Authorized official

Name
Brian D Carrico, DCNPI 1811048515
Title
Owner
Phone
(310) 540-9699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

21707 Hawthorne Blvd
Ste 201
Torrance, CA 90503

Mailing address

21707 Hawthorne Blvd
Ste 201
Torrance, CA 90503
Phone (310) 540-9699

National Provider Directory

National Provider Directory
Tax ID family
Performance Health Medical Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1922145911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21707 HAWTHORNE BLVD",
            "address_2": "STE 201",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90503",
            "telephone_number": "310-540-9699",
            "fax_number": "310-540-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21707 HAWTHORNE BLVD",
            "address_2": "STE 201",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90503",
            "telephone_number": "310-540-9699",
            "fax_number": "310-540-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE HEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2009-04-22",
        "status": "A",
        "authorized_official_last_name": "CARRICO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-540-9699",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.