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Contact Information

WESTSIDE PREMIER MED GRP
17330 BEAR VALLEY RD STE 105
VICTORVILLE, CA92395
 Phone: 760-245-8182
 Fax: 760-245-2123
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
 

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for WESTSIDE PREMIER MED GRP

NPI Number 1376680124
LBN Legal business name WESTSIDE PREMIER MED GRP
Authorized official KIM AMMERMAN - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/31/2007
Last updated 09/11/2025 - About 9 months ago
Identifiers
CA License # A36514
CA License # DC21523
CA License # DC27666
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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