Chino Medical Group, Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

CHINO MEDICAL GROUP, INC

Doing business as

My Family Medical Group

Practice address

5475 Walnut Ave
Chino, CA 91710-2609

Phone

(909) 591-6446

Fax

(909) 591-1309

NPI assigned

May 24, 2006

Last updated

Jan 1, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prasad Jeereddi, MD

Title

Ceo

Phone

(909) 591-6446

Specialties & licenses 6

Addresses

Other names 1

• My Family Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 143

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica I Cifuentes, NP

  • Family Nurse Practitioner
  • Chino, CA
  • NPI 1508579665
  Medicare reassignment Care Compare group NPD
• Nayan R. Shah, M.D.

  • Family Medicine Physician
  • Chino, CA
  • NPI 1457365553
  Medicare reassignment Care Compare group NPD
• Heather Michelle Sykes, MSPA-C

  • Medical Physician Assistant
  • Chino, CA
  • NPI 1952730061
  Medicare reassignment Care Compare group
• Veronica Castaneda, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Downey, CA
  • NPI 1164965596
  Medicare reassignment NPD
• Subash Chander, M.D

  • Family Medicine Physician
  • Chino, CA
  • NPI 1417003930
  Medicare reassignment NPD
• Angela Collins

  • Family Nurse Practitioner
  • Downey, CA
  • NPI 1235567538
  Medicare reassignment NPD
• Tarek Ezzeddine, MD

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1740471879
  Medicare reassignment NPD
• Tim Tien Le, D.O.

  • Family Medicine Physician
  • Santa Ana, CA
  • NPI 1366480188
  Medicare reassignment NPD
• Jose Alejandro Lira, M.D.

  • Internal Medicine Physician
  • Chino, CA
  • NPI 1821038985
  Medicare reassignment NPD
• Teresa Louie, FNP-C

  • Family Nurse Practitioner
  • Chino, CA
  • NPI 1174914303
  Medicare reassignment NPD
• Venkata S.R. Pulakanti, M.D.

  • Internal Medicine Physician
  • Santa Ana, CA
  • NPI 1356521843
  Medicare reassignment NPD
• Deslin Thomas, M.D

  • Family Medicine Physician
  • Diamond Bar, CA
  • NPI 1679757124
  Medicare reassignment NPD

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735689600000",
    "number": "1790730786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5475 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609",
            "telephone_number": "909-591-6446",
            "fax_number": "909-591-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609",
            "telephone_number": "909-591-6446",
            "fax_number": "909-591-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINO MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A",
        "authorized_official_last_name": "JEEREDDI",
        "authorized_official_first_name": "PRASAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-591-6446",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Family Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chino Care Inc. (Chino Care ADHC)
• Chino Emergency Medical Associates
• Chino Emergency Medical Associates, Inc.
• Chino Family Optometry Inc
• Chino Medical Group, Inc (My Family Medical Group)
• Chino Optometry Center
• Chino Pediatrics Medical Clinic, Inc.
• Chino Physical Therapy Inc.
• Chino Premier Surgery Center Limited Partnership
• Chino Spectrum Optometry PC

• Health Maintenance Organization in Chino, CA
• Providers in Chino, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2025; 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.