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Organization
CHINO MEDICAL GROUP, INC
Active
Organization
CHINO MEDICAL GROUP, INC
Active
Other names
My Family Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
PRASAD JEEREDDI MD (CEO)
(909) 591-6446
Entity
Organization
Contact information
Practice address
5475 WALNUT AVE, CHINO, CA 91710-2609
(909) 591-6446
(909) 591-1309
Mailing address
5475 WALNUT AVE, CHINO, CA 91710-2609
(909) 591-6446
(909) 591-1309
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
302R00000X
Health Maintenance Organization
Primary
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
Other
Enumeration date
05/24/2006
Last updated
01/01/2025
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