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General NPI Number Information
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NPI Number | 1821554866
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Entity Type | Organization
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Legal Business Name | CHAPARRAL MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 5475 WALNUT AVE UNIT C
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City | CHINO
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State | CA
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Zip | 91710-2609
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Country | US
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Telephone | 909-465-0209
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Fax | 909-465-0318
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Provider Business Mailing Address
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Address Line | 840 TOWNE CENTER DRIVE
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City | POMONA
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State | CA
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Zip | 91767-5900
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Country | US
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Telephone | 909-398-1550
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Fax | 909-398-1488
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | PRASAD A JEEREDDI
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Credential | M.D.
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Telephone | 909-398-1550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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