Chino Medical Group, Inc
Organization Active NPI Health Maintenance Organization · Chino, CA
NPI 1790730786 · NPPES record last updated Jan 1, 2025
Key facts
- NPI
- 1790730786
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Maintenance Organization 302R00000X
- Legal business name
- CHINO MEDICAL GROUP, INC
- Practice address
- 5475 Walnut Ave
Chino, CA 91710-2609 - Phone
- (909) 591-6446
- Fax
- (909) 591-1309
- NPI assigned
- May 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Prasad Jeereddi, MD
- Title
- Ceo
- Phone
- (909) 591-6446
Practitioners 143
-
Nayan R. Shah, M.D.
-
Heather Michelle Sykes, MSPA-C
-
Veronica Castaneda, NURSE PRACTITIONER
-
Subash Chander, M.D
-
Tarek Ezzeddine, MD
-
Tim Tien Le, D.O.
-
Jose Alejandro Lira, M.D.
-
Teresa Louie, FNP-C
-
Venkata S.R. Pulakanti, M.D.
-
Deslin Thomas, M.D
-
Wanda Althea Wilburn, M.D.
-
Shin-Shen Wu, M.D.
-
Stephen Anthony Harvey, P.A.-C
-
Anna Ninnette Saravia, MSPA-C
-
Daniel Hau Tran, PA-C, MPAS
-
Joseph Ahdoot, MD
-
Mohamad Al Sayed, MD
-
Joseph Manuel Alonzo, M.D.
-
Farah A Ameeri, D.O.
-
Seerat Anand, M.D.
-
Sam Arasoghli, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050421000800 | CA | Part B Supplier - Clinic/Group Practice | 8325086184 |
Receives reassigned benefits from 18 practitioners Practice locations: Chino, CA |
National Provider Directory
Locations
2140 Grand Ave
Ste 230
Chino Hills, CA 91709
Phone (909) 244-8902
9655 Monte Vista Ave
Ste 402
Montclair, CA 91763
Phone (909) 591-6575
9655 Monte Vista Ave
Montclair, CA 91763
9645 Monte Vista Ave
Ste 301
Montclair, CA 91763
Phone (909) 621-7321
1940 N Orange Grove Ave
Ste B
Pomona, CA 91767
Phone (909) 620-1974
1866 N Orange Grove Ave
Ste 10
Pomona, CA 91767
Phone (909) 392-0562
790 E Bonita Ave
#2
Pomona, CA 91767
9190 Haven Ave
Ste 210
Rancho Cucamonga, CA 91730
Phone (909) 466-7779
9481 Haven Ave
Rancho Cucamonga, CA 91730
8237 Rochester Ave
Ste 110
Rancho Cucamonga, CA 91730
Phone (909) 477-3310
10837 Laurel St
Ste 101
Rancho Cucamonga, CA 91730
Phone (562) 208-1600
2001 Santa Monica Blvd
Ste 483W
Santa Monica, CA 90404
Phone (310) 998-1181
886 W Foothill Blvd
Ste G
Upland, CA 91786
Phone (909) 949-6500
954 W Foothill Blvd
Ste B
Upland, CA 91786
Phone (909) 949-7500
600 N 13th Ave
Upland, CA 91786
Phone (909) 931-4515
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Diagnostic Radiology Physician |
2085R0202X | |||
| Health Maintenance Organization | 302R00000X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Family Nurse Practitioner | 363LF0000X |
Addresses
Primary practice location
5475 Walnut Ave
Chino, CA 91710-2609
Mailing address
5475 Walnut Ave
Chino, CA 91710-2609
Phone (909) 591-6446
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0059290 | Medicaid | CA |
Other names
- My Family Medical Group
Other providers in Chino, CA
- Chino Care Inc.
- Chino Emergency Medical Associates
- Chino Emergency Medical Associates, Inc.
- Chino Family Optometry Inc
- Chino Medical Group, Inc
- Chino Optometry Center
- Chino Pediatrics Medical Clinic, Inc.
- Chino Physical Therapy Inc.
- Chino Premier Surgery Center Limited Partnership
- Chino Spectrum Optometry PC
All providers in Chino, CA · Health Maintenance Organization in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.