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PRAIRIE MEDICAL GROUP
NPI 1194846410
Specialist in Marina Del Rey, CA

Active since April 03, 2007
4644 LINCOLN BLVD, SUITE 428, MARINA DEL REY, CA 90292(310) 214-8677(310) 921-1718 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Prairie Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRAIRIE MEDICAL GROUP (NPI 1194846410) is a healthcare organization registered as a specialist in Marina Del Rey, California and active in the NPI registry since April 2007. The organization lists Christopher C Chidi, President, as its authorized official.

NPPES Registry Identity

NPI1194846410
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePRAIRIE MEDICAL GROUP
Location Address4644 LINCOLN BLVD, SUITE 428Marina Del Rey, CA 90292
Mailing AddressDept 2834Los Angeles, CA 90084 · (310) 306-1888 · Fax (310) 577-8290
Phone(310) 214-8677
Fax(310) 921-1718
Organization SubpartNo
Authorized OfficialChristopher C ChidiPresident · (310) 214-8677
Enumeration DateApril 3, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1194846410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · 058963
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
4644 LINCOLN BLVD, Marina Del Rey, CA 90292
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Other Identifiers 1

MedicaidGR0078675CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIAN KEITH ESTWICK MD
Ophthalmology
4644 LINCOLN BLVD, STE #430
MARINA DEL REY, CA 90292
Los Angeles County (310) 390-2420
BRIAN K. ESTWICK, M.D., INC.
Ophthalmology
4644 LINCOLN BLVD, SUITE 430
MARINA DEL REY, CA 90292
Los Angeles County (310) 390-2420
JONATHAN D. RAND, M.D. INC
Internal Medicine
4644 LINCOLN BLVD, 113
MARINA DEL REY, CA 90292
Los Angeles County (310) 821-9800
CASTORIA SEYMORE, JR. MD A PROFESSIONAL CORPERATION
Anesthesiology (Pain Medicine)
4644 LINCOLN BLVD, 424
MARINA DEL REY, CA 90292
Los Angeles County (131) 048-2690
DR. MICHAEL GORNIOWSKY M.D.
Family Medicine
4644 LINCOLN BLVD, SUITE 428
MARINA DEL REY, CA 90292
Los Angeles County (310) 306-1888
PACIFIC HEARING, INC.
Specialist
4644 LINCOLN BLVD, SUITE # 409
MARINA DEL REY, CA 90292
Los Angeles County (310) 574-1116
DR. ANTOINE ROBERTS M.D.
Orthopaedic Surgery
4644 LINCOLN BLVD, SUITE 101
MARINA DEL REY, CA 90292
Los Angeles County (310) 577-8500
DR. ALAN JEFFREY STEINBERG MD
Internal Medicine
4644 LINCOLN BLVD, #111
MARINA DEL REY, CA 90292
Los Angeles County (310) 306-6966

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prairie Medical Group's NPI number?

The NPI number for Prairie Medical Group is 1194846410. It was assigned to this organization in the NPPES registry on April 3, 2007.

Where is Prairie Medical Group located?

Prairie Medical Group is located at 4644 Lincoln Blvd Suite 428, Marina Del Rey, CA 90292. The listed phone number is (310) 214-8677.

What is Prairie Medical Group's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Prairie Medical Group was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.