# CHINO MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** My Family Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790730786
- **Authorized official:** PRASAD JEEREDDI MD (CEO)
- **Authorized official phone:** (909) 591-6446

## Contact information

- **Practice address:** 5475 WALNUT AVE, CHINO, CA 91710-2609
- **Practice address phone:** (909) 591-6446
- **Practice address fax:** (909) 591-1309
- **Mailing address:** 5475 WALNUT AVE, CHINO, CA 91710-2609
- **Mailing address phone:** (909) 591-6446
- **Mailing address fax:** (909) 591-1309

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |

## Other

- **Enumeration date:** 05/24/2006
- **Last updated:** 01/01/2025