NPIMap

Organization Active NPI

Chaparral Medical Group Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Pomona, CA
National Provider Identifier
1114989241
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
CHAPARRAL MEDICAL GROUP INC
Practice address
1904 N Orange Grove Ave
Chaparral Medical Group
Pomona, CA 91767-3008
Phone
(909) 469-1823
Fax
(909) 469-1827
NPI assigned
Apr 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Adrienne M Walker
Title
Contracts Administrator
Phone
(909) 398-1550

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

1904 N Orange Grove Ave
Chaparral Medical Group
Pomona, CA 91767-3008

Mailing address

840 Towne Center Dr
Administrative Resources
Pomona, CA 91767-5900
Phone (909) 398-1550

Other identifiers 1

IdentifierTypeStateIssuer
GR0052958MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000605 CA Part B Supplier - Clinic/Group Practice 6800709403 Receives reassigned benefits from 139 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Claremont, CA; Pomona, CA

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations (25 of 35)

109 H St
Bakersfield, CA 93304
Phone (213) 497-3218

5475 Walnut Ave
Ste C
Chino, CA 91710
Phone (909) 465-0292

5385 Walnut Ave
#34
Chino, CA 91710

5385 Walnut Ave
Ste 34
Chino, CA 91710
Phone (909) 465-0292

15944 Los Serranos Country Club Dr
Ste 270
Chino Hills, CA 91709

1601 Monte Vista Ave
Ste 270
Claremont, CA 91711
Phone (909) 537-7303

760 Washburn Ave
Ste 7
Corona, CA 92882
Phone (951) 735-2311

236 W College St
Covina, CA 91723
Phone (626) 732-2200

Virtual Visit Only Provider
Pasadena, CA 91199

1940 N Orange Grove Ave
Ste Ab
Pomona, CA 91767
Phone (909) 865-6900

250 W Bonita Ave
Ste 160
Pomona, CA 91767
Phone (909) 593-1002

1900 Royalty Dr
Ste 205
Pomona, CA 91767
Phone (909) 623-1805

1866 N Orange Grove Ave
Ste 108
Pomona, CA 91767

1904 N Orange Grove Ave
Ste 202
Pomona, CA 91767

1866 N Orange Grove Ave
Ste 20
Pomona, CA 91767

1818 N Orange Grove Ave
Ste 102
Pomona, CA 91767
Phone (909) 622-3166

1818 N Orange Grove Ave
Ste 307
Pomona, CA 91767
Phone (909) 326-2853

1818 N Orange Grove Ave
Ste 308
Pomona, CA 91767
Phone (909) 622-6050

160 E Artesia St
Ste 250
Pomona, CA 91767

1904 N Orange Grove Ave
Pomona, CA 91767
Phone (909) 469-1823

1866 N Orange Grove Ave
Ste 102C
Pomona, CA 91767

350 Vinton Ave
Ste 202
Pomona, CA 91767
Phone (909) 973-1148

1866 N Orange Grove Ave
Ste 102A
Pomona, CA 91767

790 E Foothill Blvd
Pomona, CA 91767

1866 N Orange Grove Ave
Ste 102B
Pomona, CA 91767
Phone (909) 620-4373

Practitioners & affiliated clinicians

Practitioners 72

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 72

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1114989241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "address_2": "ADMINISTRATIVE RESOURCES",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 N ORANGE GROVE AVE",
            "address_2": "CHAPARRAL MEDICAL GROUP",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673008",
            "telephone_number": "909-469-1823",
            "fax_number": "909-469-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAPARRAL MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CONTRACTS ADMINISTRATOR",
        "authorized_official_telephone_number": "909-398-1550",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0052958",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.