Healthcare Provider Details

I. General information

NPI: 1447515911
Provider Name (Legal Business Name): PROPRIUS HEALTH MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9604 ARTESIA BLVD STE 104
BELLFLOWER CA
90706-8043
US

IV. Provider business mailing address

9604 ARTESIA BLVD STE 104
BELLFLOWER CA
90706-8043
US

V. Phone/Fax

Practice location:
  • Phone: 562-663-1765
  • Fax: 562-633-7853
Mailing address:
  • Phone: 562-663-1765
  • Fax: 562-633-7853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA110631
License Number StateCA

VIII. Authorized Official

Name: ANDREI N DOKUKIN
Title or Position: PRESIDENT
Credential: MD
Phone: 917-647-5031