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General NPI Number Information
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NPI Number | 1902704604
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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 | 10/30/2026
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Last Update Date | 10/30/2026
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Provider Practice Location Address
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Address Line | 1131 W 6TH ST STE 151
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City | ONTARIO
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State | CA
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Zip | 91762-1121
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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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Provider Business Mailing Address
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Address Line | 8605 SANTA MONICA BOULEVARD PMB 17538
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069
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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 | PRESIDENT
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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 | 207Q00000X
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Taxonomy Name | Family 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 | 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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