| Chaparral Medical Group Inc | |
|
630 North 13th Ave Suite B Upland CA 91786-4956 | |
| (909) 982-2719 | |
| (909) 946-9931 |
| Full Name | Chaparral Medical Group Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 630 North 13th Ave, Upland, California |
| Authorized Official Name and Position | Adrienne M Walker (CONTRACTS ADMINISTRATOR) |
| Authorized Official Contact | 9093951550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chaparral Medical Group Inc 840 Towne Center Dr Administrative Resources Pomona CA 91767-5900 Ph: (909) 398-1550 | Chaparral Medical Group Inc 630 North 13th Ave Suite B Upland CA 91786-4956 Ph: (909) 982-2719 |
| NPI Number | 1386607950 |
|---|---|
| Provider Enumeration Date | 04/06/2006 |
| Last Update Date | 10/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386607950 | NPI | - | NPPES |
| GR005295A | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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