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GREAT HARBOR FAMILY & SPORTS MEDICINE, INC
NPI 1962629162
General Practice in San Pedro, CA

Active since April 19, 2007
1294 W 6TH ST, SUITE 200, SAN PEDRO, CA 90731(310) 521-1311(310) 514-1313 Get Directions Write a Review

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

About Great Harbor Family & Sports Medicine, Inc NPPES

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

GREAT HARBOR FAMILY & SPORTS MEDICINE, INC (NPI 1962629162) is a healthcare organization registered as a general practice in San Pedro, California and active in the NPI registry since April 2007. The organization lists Elissa Schlichter, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1962629162
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameGREAT HARBOR FAMILY & SPORTS MEDICINE, INC
Location Address1294 W 6TH ST, SUITE 200San Pedro, CA 90731-2987
Mailing Address1294 W 6th St, Suite 200San Pedro, CA 90731-2987 · (310) 521-1311 · Fax (310) 514-1313
Phone(310) 521-1311
Fax(310) 514-1313
Organization SubpartNo
Authorized OfficialElissa SchlichterMedical Director · (310) 521-1311
Enumeration DateApril 19, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1962629162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · 20A7368
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1294 W 6TH ST, San Pedro, CA 90731
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 15

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

BORROWED STAR PSYCHOLOGY GROUP, INC
Psychologist (Clinical)
1294 W 6TH ST, SUITE 105
SAN PEDRO, CA 90731
Los Angeles County (310) 902-6089
DR. GRACE C. PETTERSON MD
Specialist
1294 W 6TH ST, STE#102
SAN PEDRO, CA 90731
Los Angeles County (310) 832-6487
KIMBERLY R WALTON MD INC
Obstetrics & Gynecology (Obstetrics)
1294 W 6TH ST, 201-A
SAN PEDRO, CA 90731
Los Angeles County (310) 831-6515
SAN PEDRO PEDIATRICS MED GRP INC
Pediatrics
1294 W 6TH ST, STE #102
SAN PEDRO, CA 90731
Los Angeles County (310) 832-6487
MICHAEL T O'DONNELL DPT, OCS
Physical Therapist
1294 W 6TH ST, SUITE 101
SAN PEDRO, CA 90731
Los Angeles County (310) 547-1850
MICHAEL CULMER M.D.
Pediatrics
1294 W 6TH ST, SUITE 104
SAN PEDRO, CA 90731
Los Angeles County (321) 054-8911
DR. ANDREW P NOVOM MD
Specialist
1294 W 6TH ST, STE#102
SAN PEDRO, CA 90731
Los Angeles County (310) 832-6487
GENESA WAGONER M.D.
Pediatrics
1294 W 6TH ST, SUITE 104
SAN PEDRO, CA 90731
Los Angeles County (310) 548-9118

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 Great Harbor Family & Sports Medicine, Inc's NPI number?

The NPI number for Great Harbor Family & Sports Medicine, Inc is 1962629162. It was assigned to this organization in the NPPES registry on April 19, 2007.

Where is Great Harbor Family & Sports Medicine, Inc located?

Great Harbor Family & Sports Medicine, Inc is located at 1294 W 6th St Suite 200, San Pedro, CA 90731. The listed phone number is (310) 521-1311.

What is Great Harbor Family & Sports Medicine, Inc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Great Harbor Family & Sports Medicine, Inc 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.