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NPI Code Detail

MEDICARE: CHAPARRAL MEDICAL GROUP INC

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 License Number State
1133V00000XRegistered Dietitian
2207R00000XInternal Medicine Physician
3207RE0101XEndocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number : 1114989241
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 : ADMINISTRATIVE RESOURCES
City : POMONA
State : CA
Zip : 91767-5900
Country : US
Telephone Number : 909-398-1550
Fax Number : 909-398-1573
Provider Business Practice Location Address
First Line : 1904 N ORANGE GROVE AVE
Second Line : CHAPARRAL MEDICAL GROUP
City : POMONA
State : CA
Zip : 91767-3008
Country : US
Telephone Number : 909-469-1823
Fax Number : 909-469-1827
Authorized Official
Title or Position : CONTRACTS ADMINISTRATOR
Name : MRS. ADRIENNE M WALKER
Credential :
Telephone Number : 909-398-1550
Provider Enumeration Date : 04/04/2006
Last Update Date : 03/14/2022

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Directions to “CHAPARRAL MEDICAL GROUP INC ” Practice Location

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