Organization
CHAPARRAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRASAD JEEREDDI (CEO)
(909) 469-1823
Entity
Organization
Contact information
Practice address
1940 N ORANGE GROVE AVE STE A&B, POMONA, CA 91767-3002
(909) 865-6900
(909) 865-6300
Mailing address
840 TOWNE CENTER DR, POMONA, CA 91767-5900
(909) 398-1550
(909) 398-1573
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
A76312
CA
Other
Enumeration date
03/10/2014
Last updated
09/25/2023
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