Healthcare Provider Details

I. General information

NPI: 1528020112
Provider Name (Legal Business Name): CHAPARRAL MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 EAST BONITA AVE CHAPARRAL MEDICAL GROUP
POMONA CA
91767-1906
US

IV. Provider business mailing address

840 TOWNE CENTER DR ADMINISTRATIVE RESOURCES
POMONA CA
91767-5900
US

V. Phone/Fax

Practice location:
  • Phone: 909-447-8585
  • Fax: 909-447-8593
Mailing address:
  • Phone: 909-398-1550
  • Fax: 909-398-1573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS LAUREN ARROYO
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 909-398-1550