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Contact Information

PERFORMANCE HEALTH MEDICAL GROUP
21707 HAWTHORNE BLVD
STE 201
TORRANCE, CA90503
 Phone: 310-540-9699
 Fax: 310-540-9486
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Rehabilitation

111NR0400X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for PERFORMANCE HEALTH MEDICAL GROUP

NPI # 1922145911
LBN Legal business name PERFORMANCE HEALTH MEDICAL GROUP
Authorized official BRIAN CARRICO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/31/2007
Last updated 04/22/2009 - About 17 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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