OrganizationActive
Premier Weight Loss Medical Clinic
NPI 1407115710 · Dietary Manager · San Pedro, CA
Premier Weight Loss Medical Clinic is a Dietary Manager organization in San Pedro, CA (NPI 1407115710).
Provider details
- NPI number
- 1407115710
- Entity type
- Organization
- Primary specialty
- Dietary ManagerDietary & Nutritional Service Providers
- Organization subpart
- No
- Authorized official
- Kristina Kutsina, Manager(310) 832-9080
Specialties & taxonomies
Dietary & Nutritional Service Providers
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
719 S Averill Ave
San Pedro, CA 90732-3813
Phone: (310) 832-9080
Fax: (310) 832-9027
Street-level locationGet directions
Mailing address
719 S Averill Ave
San Pedro, CA 90732-3813
Registry dates
- Enumerated
- 2012-05-07
- Last updated
- 2012-05-07
Frequently asked questions
- What is Premier Weight Loss Medical Clinic's NPI number?
- Premier Weight Loss Medical Clinic's National Provider Identifier (NPI) is 1407115710, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Premier Weight Loss Medical Clinic?
- Premier Weight Loss Medical Clinic is classified in the NPPES registry as Dietary Manager (Dietary & Nutritional Service Providers).
- Where is Premier Weight Loss Medical Clinic located?
- Premier Weight Loss Medical Clinic's practice location on file with NPPES is 719 S Averill Ave, San Pedro, CA 90732-3813.
- What is Premier Weight Loss Medical Clinic's phone number?
- The practice phone number listed in the NPPES registry for Premier Weight Loss Medical Clinic is (310) 832-9080.
- Who is the authorized official for Premier Weight Loss Medical Clinic?
- The authorized official listed on Premier Weight Loss Medical Clinic's NPPES record is Kristina Kutsina, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Premier Weight Loss Medical Clinic's NPI active?
- Yes — Premier Weight Loss Medical Clinic's NPI (1407115710) is active in the NPPES registry as of the last update on 2012-05-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.