NPIMap

Organization Active NPI

Chaparral Medical Group, Inc.

  • Internal Medicine Physician
  • Pomona, CA
National Provider Identifier
1902111024
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CHAPARRAL MEDICAL GROUP, INC.
Practice address
1818 N Orange Grove Ave
Suite 204
Pomona, CA 91767-3028
Phone
(909) 620-7200
Fax
(909) 620-5800
NPI assigned
Aug 12, 2010
Last updated
Apr 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Authorized official

Name
Adrienne Walker
Title
Contracts Manager
Phone
(909) 398-1550

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X CA

Addresses

Primary practice location

1818 N Orange Grove Ave
Suite 204
Pomona, CA 91767-3028

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1500

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
Tax ID family
Venkata Pulakanti MD36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

1818 N Orange Grove Ave
Ste 204
Pomona, CA 91767
Phone (909) 620-7200

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1902111024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1500",
            "fax_number": "909-398-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 N ORANGE GROVE AVE",
            "address_2": "SUITE 204",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673028",
            "telephone_number": "909-620-7200",
            "fax_number": "909-620-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAPARRAL MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_title_or_position": "CONTRACTS MANAGER",
        "authorized_official_telephone_number": "909-398-1550"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Apr 22, 2013; 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.