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
585 NORTH MOUNTAIN AVE, SUITE A, UPLAND, CA 91786-8516
(909) 946-2228
(909) 946-8007
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
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR005295D
—
CA
Enumeration date
04/04/2006
Last updated
10/17/2007
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