MEDICARE: CHAPARRAL MEDICAL GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	207UN0901X	Nuclear Cardiology Physician	CA
2	251X00000X	Supports Brokerage Agency
3	171M00000X	Case Manager/Care Coordinator
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
5	207RS0012X	Sleep Medicine (Internal Medicine) Physician
6	207RP1001X	Pulmonary Disease Physician
7	207Q00000X	Family Medicine Physician	CA
8	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	CA
9	207R00000X	Internal Medicine Physician	CA
10	207RC0000X	Cardiovascular Disease Physician	CA

General Provider Information

NPI Number	:	1346639952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAPARRAL MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	840 TOWNE CENTER DR
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-5900
Country	:	US
Telephone Number	:	909-398-1550
Fax Number	:	909-398-1488

Provider Business Practice Location Address
First Line	:	8330 RED OAK ST STE 101
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-0603
Country	:	US
Telephone Number	:	909-987-4922
Fax Number	:	909-466-1190

Authorized Official
Title or Position	:	CEO
Name	:	PRASAD A JEEREDDI
Credential	:	M.D.
Telephone Number	:	909-398-1550

Provider Enumeration Date	:	01/20/2015
Last Update Date	:	02/24/2026

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