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Organization

CHAPARRAL MEDICAL GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ADRIENNE M WALKER (CONTRACTS ADMINISTRATOR)
(909) 398-1550
Entity
Organization

Contact information

Practice address
1904 N ORANGE GROVE AVE, CHAPARRAL MEDICAL GROUP, POMONA, CA 91767-3008
(909) 469-1823
(909) 469-1827
Mailing address
840 TOWNE CENTER DR, ADMINISTRATIVE RESOURCES, POMONA, CA 91767-5900
(909) 398-1550
(909) 398-1573

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
207R00000X
Internal Medicine Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0052958
CA
Enumeration date
04/04/2006
Last updated
03/14/2022
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