| Chaparral Medical Group, Inc. | |
|
9190 Haven Avenue Ste. 101, 102, 210, 200 Rancho Cucamonga CA 91730-5431 | |
| (909) 581-6732 | |
| (909) 581-6737 |
| Full Name | Chaparral Medical Group, Inc. |
|---|---|
| Speciality | Dermatology |
| Location | 9190 Haven Avenue, Rancho Cucamonga, California |
| Authorized Official Name and Position | Arul Karthik Balaramalingam (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9093981550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chaparral Medical Group, Inc. 840 Towne Center Dr Pomona CA 91767-5900 Ph: (909) 398-1550 | Chaparral Medical Group, Inc. 9190 Haven Avenue Ste. 101, 102, 210, 200 Rancho Cucamonga CA 91730-5431 Ph: (909) 581-6732 |
| NPI Number | 1093777666 |
|---|---|
| Provider Enumeration Date | 04/06/2006 |
| Last Update Date | 03/11/2022 |
| Medicare PECOS PAC ID | 6800709403 |
|---|---|
| Medicare Enrollment ID | O20040331001684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093777666 | NPI | - | NPPES |
| GR0052956 | Medicaid | CA |
| Provider Name | Mary N Kasem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982639993 PECOS PAC ID: 2567366479 Enrollment ID: I20031121000796 |
| Provider Name | Ewa H Konca |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1134197528 PECOS PAC ID: 1951201888 Enrollment ID: I20040108001147 |
| Provider Name | Prasad A Jeereddi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1821058470 PECOS PAC ID: 7618880345 Enrollment ID: I20040421001852 |
| Provider Name | Daryoosh Valamanesh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205804671 PECOS PAC ID: 2668463555 Enrollment ID: I20040519001633 |
| Provider Name | Heather L Davis Kingston |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154390391 PECOS PAC ID: 9537143813 Enrollment ID: I20040615000712 |
| Provider Name | Sharyn D Brekhus |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1003995093 PECOS PAC ID: 2365429750 Enrollment ID: I20040702000768 |
| Provider Name | Jayapal Reddy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073573903 PECOS PAC ID: 1850360348 Enrollment ID: I20040930001022 |
| Provider Name | Redemption G Geronimo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497723803 PECOS PAC ID: 7113966318 Enrollment ID: I20050427000759 |
| Provider Name | Ramakrishna Reddy Thumati |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841268240 PECOS PAC ID: 2264345990 Enrollment ID: I20050517000591 |
| Provider Name | William L Discepolo |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1932308137 PECOS PAC ID: 4385687037 Enrollment ID: I20050603000853 |
| Provider Name | Padmini P Tummala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669519500 PECOS PAC ID: 1153306303 Enrollment ID: I20050715000828 |
| Provider Name | Jaffar A Tremazi |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1649248782 PECOS PAC ID: 3072546712 Enrollment ID: I20050914000325 |
| Provider Name | Gregory R Lercel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942232723 PECOS PAC ID: 8527092881 Enrollment ID: I20050926000688 |
| Provider Name | Sujatha Srikanth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124085287 PECOS PAC ID: 1355366535 Enrollment ID: I20051006000571 |
| Provider Name | Albert K Chong |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700819653 PECOS PAC ID: 5890718498 Enrollment ID: I20060110000584 |
| Provider Name | Gary G Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871513002 PECOS PAC ID: 7416952924 Enrollment ID: I20060915000234 |
| Provider Name | Peter J Niciforos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356359277 PECOS PAC ID: 3577563451 Enrollment ID: I20061226000194 |
| Provider Name | Harvey D Cohen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972517423 PECOS PAC ID: 5698747434 Enrollment ID: I20070302000292 |
| Provider Name | Rishu Marwaha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457490294 PECOS PAC ID: 9032213012 Enrollment ID: I20070330000571 |
| Provider Name | Glenn Y Miya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912967894 PECOS PAC ID: 1850498247 Enrollment ID: I20070518000551 |
| Provider Name | Praveena Jeereddi |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1346218740 PECOS PAC ID: 0446281513 Enrollment ID: I20070720000255 |
| Provider Name | Muthusamy Muthiah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679541148 PECOS PAC ID: 0143316950 Enrollment ID: I20071009000912 |
| Provider Name | Venkata Subba Reddy Pulakanti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356521843 PECOS PAC ID: 7113937913 Enrollment ID: I20071024000362 |
| Provider Name | Rita K Pradhan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1336117738 PECOS PAC ID: 6800977430 Enrollment ID: I20080121000264 |
| Provider Name | Hla Myint Maung Shin Jian Myint Hwang |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1356357560 PECOS PAC ID: 4688621113 Enrollment ID: I20080222000443 |
| Provider Name | Srinath Samudrala |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1558302943 PECOS PAC ID: 7113005182 Enrollment ID: I20080416000671 |
| Provider Name | Donna E Dudziak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275630568 PECOS PAC ID: 4183688013 Enrollment ID: I20080514000914 |
| Provider Name | Nitanth R Vangala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861690141 PECOS PAC ID: 0547328056 Enrollment ID: I20081027000684 |
| Provider Name | Maria Velma D Yep |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316090103 PECOS PAC ID: 5890855209 Enrollment ID: I20081114000577 |
| Provider Name | David Robles |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1326156233 PECOS PAC ID: 9436214111 Enrollment ID: I20090212000204 |
| Provider Name | Manjusha Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609077197 PECOS PAC ID: 4688721558 Enrollment ID: I20090409000648 |
| Provider Name | Sam Arasoghli |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1770685935 PECOS PAC ID: 4385797802 Enrollment ID: I20090731000256 |
| Provider Name | Sarika Jain |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1205846250 PECOS PAC ID: 6507954567 Enrollment ID: I20090910000656 |
| Provider Name | Gurbinder Singh Sadana |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205898327 PECOS PAC ID: 8527971266 Enrollment ID: I20090911000584 |
| Provider Name | Rakesh Sinha |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1306006358 PECOS PAC ID: 9638225642 Enrollment ID: I20090916000424 |
| Provider Name | Nadir A Eltahir |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053389338 PECOS PAC ID: 9830236660 Enrollment ID: I20091027000358 |
| Provider Name | Jagtar Dhadwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801865563 PECOS PAC ID: 4183786452 Enrollment ID: I20091027000652 |
| Provider Name | Lori Vanyo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528036910 PECOS PAC ID: 5395769855 Enrollment ID: I20091027000768 |
| Provider Name | Daniel J Lee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659533115 PECOS PAC ID: 5890830004 Enrollment ID: I20100226000338 |
| Provider Name | Mysore R Nagaraja |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760451298 PECOS PAC ID: 2264561547 Enrollment ID: I20100525000514 |
| Provider Name | Neil R Soni |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1306054150 PECOS PAC ID: 1052443488 Enrollment ID: I20100720000734 |
| Provider Name | Haritha Alla |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487739835 PECOS PAC ID: 8426944919 Enrollment ID: I20101118001098 |
| Provider Name | Sudhir K Reddy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720015282 PECOS PAC ID: 6103009618 Enrollment ID: I20110321001022 |
| Provider Name | Sundararajan Srikanth |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1104934082 PECOS PAC ID: 0042497414 Enrollment ID: I20110613000239 |
| Provider Name | Khader Kamel Abounasr |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1780884015 PECOS PAC ID: 4981882404 Enrollment ID: I20110630000630 |
| Provider Name | Derrick N Raptis |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1679749683 PECOS PAC ID: 9931368545 Enrollment ID: I20120316000326 |
| Provider Name | Alya D Torna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306051024 PECOS PAC ID: 2062543788 Enrollment ID: I20120523000506 |
| Provider Name | Kavoos C Nazeri |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1477731644 PECOS PAC ID: 9830352087 Enrollment ID: I20120525000156 |
| Provider Name | Uzma A Waraich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528221843 PECOS PAC ID: 9739336777 Enrollment ID: I20120828000185 |
| Provider Name | Alexander D Stein |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1760431654 PECOS PAC ID: 1951324961 Enrollment ID: I20121105000190 |
| Provider Name | Johnnie M Woodson |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1780727750 PECOS PAC ID: 0547202079 Enrollment ID: I20121112000055 |
| Provider Name | Leslie Theroith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841473097 PECOS PAC ID: 7911150081 Enrollment ID: I20130124000063 |
| Provider Name | Guangqiang Gao |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1124322086 PECOS PAC ID: 9335384833 Enrollment ID: I20130404000532 |
| Provider Name | Ramanna Merla |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336343912 PECOS PAC ID: 3971680802 Enrollment ID: I20130801000847 |
| Provider Name | Nathaniel Soriano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679890271 PECOS PAC ID: 0941436216 Enrollment ID: I20131114000647 |
| Provider Name | Pratibha Kayastha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942601281 PECOS PAC ID: 2769704527 Enrollment ID: I20141205000012 |
| Provider Name | Lydia A Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447552229 PECOS PAC ID: 2163745472 Enrollment ID: I20141217001835 |
| Provider Name | Nazia Siddiqi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1578879755 PECOS PAC ID: 7719299064 Enrollment ID: I20150630001060 |
| Provider Name | Shyam Rao |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1568729580 PECOS PAC ID: 7810209012 Enrollment ID: I20150630002811 |
| Provider Name | Nancy Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992185847 PECOS PAC ID: 1052625506 Enrollment ID: I20150728006581 |
| Provider Name | Pei Kuo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265822076 PECOS PAC ID: 3870807324 Enrollment ID: I20150728006587 |
| Provider Name | Yvette D Marquez |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1255640892 PECOS PAC ID: 7113233297 Enrollment ID: I20150903002310 |
| Provider Name | Jhonatan T Munoz Espinoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174881510 PECOS PAC ID: 1658599667 Enrollment ID: I20151229001392 |
| Provider Name | Johanna V Basa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821326380 PECOS PAC ID: 0143521625 Enrollment ID: I20151229001739 |
| Provider Name | Puneet Ghayal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336443100 PECOS PAC ID: 3274759592 Enrollment ID: I20160108002587 |
| Provider Name | Joseph A Gordon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811243652 PECOS PAC ID: 9638471311 Enrollment ID: I20160112003061 |
| Provider Name | Chris J Harper |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1013150630 PECOS PAC ID: 8527209923 Enrollment ID: I20160203001693 |
| Provider Name | Harish Yalamanchili |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578874186 PECOS PAC ID: 9335321942 Enrollment ID: I20160205000340 |
| Provider Name | Urvi Pradeep Vyas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730477142 PECOS PAC ID: 3375843980 Enrollment ID: I20160815001956 |
| Provider Name | Gaurav Parikh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144494550 PECOS PAC ID: 6103084900 Enrollment ID: I20160816000803 |
| Provider Name | Vinitha Das |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1811217300 PECOS PAC ID: 7719293653 Enrollment ID: I20161110002389 |
| Provider Name | Sundeep Adusumalli |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1639305295 PECOS PAC ID: 9133371388 Enrollment ID: I20170209001687 |
| Provider Name | Francis Mendez Munduate |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659614121 PECOS PAC ID: 8123323839 Enrollment ID: I20170213000754 |
| Provider Name | Nyein Tint |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336533447 PECOS PAC ID: 8628352879 Enrollment ID: I20170307001123 |
| Provider Name | Krishi Chanduri |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1598957540 PECOS PAC ID: 3971634353 Enrollment ID: I20170314001013 |
| Provider Name | Suneel Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275816654 PECOS PAC ID: 7416175989 Enrollment ID: I20170405001879 |
| Provider Name | Kevin Waldron |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1659314540 PECOS PAC ID: 2163466251 Enrollment ID: I20170503002825 |
| Provider Name | Anthony Gan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902223092 PECOS PAC ID: 5698041929 Enrollment ID: I20171031003306 |
| Provider Name | Christine M Montesa |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1467616581 PECOS PAC ID: 5496090714 Enrollment ID: I20181214001006 |
| Provider Name | Rishi R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891173720 PECOS PAC ID: 9133460330 Enrollment ID: I20190417001029 |
| Provider Name | Aftab A Qadir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851753545 PECOS PAC ID: 9830422393 Enrollment ID: I20190614002307 |
| Provider Name | Krishna Anurag Pulumati |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982044244 PECOS PAC ID: 7810235827 Enrollment ID: I20190709000349 |
| Provider Name | Maher Tama |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326393737 PECOS PAC ID: 4486965654 Enrollment ID: I20190731001397 |
| Provider Name | Ani Berberyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700230224 PECOS PAC ID: 3870832967 Enrollment ID: I20190814002626 |
| Provider Name | Mohammad Elbatta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316204894 PECOS PAC ID: 7618109422 Enrollment ID: I20190926003584 |
| Provider Name | Steven Daniel Hochman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730566191 PECOS PAC ID: 8921319070 Enrollment ID: I20191227000228 |
| Provider Name | Rohan Bassi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023655560 PECOS PAC ID: 1355777889 Enrollment ID: I20200131002355 |
| Provider Name | Laura Louise Rigby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831674191 PECOS PAC ID: 4486069770 Enrollment ID: I20210218002170 |
| Provider Name | Weera Sukhumthammarat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619407806 PECOS PAC ID: 5597168492 Enrollment ID: I20210729003468 |
| Provider Name | Carolyn Marie Dreyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386213734 PECOS PAC ID: 2567860505 Enrollment ID: I20211006000942 |
| Provider Name | Aman Sircar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386182087 PECOS PAC ID: 5092103960 Enrollment ID: I20211027002698 |
| Provider Name | Nancy Si Jia Meng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760134852 PECOS PAC ID: 0749668721 Enrollment ID: I20220602002604 |
| Provider Name | Bhavi Paresh Pandya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467892059 PECOS PAC ID: 7517231582 Enrollment ID: I20220705001680 |
| Provider Name | Pramod Theetha Kariyanna |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1881005809 PECOS PAC ID: 5193062040 Enrollment ID: I20230103002829 |
| Provider Name | Jessica Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427633205 PECOS PAC ID: 2961864509 Enrollment ID: I20230815001286 |
| Provider Name | Dallis Quang Ngo |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174055149 PECOS PAC ID: 3072990886 Enrollment ID: I20230831003254 |
| Provider Name | Annie Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992580559 PECOS PAC ID: 8820444177 Enrollment ID: I20231024000941 |
| Provider Name | Dongning Zhang |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1508215674 PECOS PAC ID: 1759822919 Enrollment ID: I20240916002587 |
Carlos R. Vigil, D.o. (a Professional Corporation) Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7974 Haven Ave, Suite 210, Rancho Cucamonga, CA 91730 Phone: 909-941-0661 Fax: 909-948-5577 | |
Bluemedplus Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10970 Arrow Rte Ste 205, Rancho Cucamonga, CA 91730 Phone: 909-446-2304 | |
California Foothills Medical Associates Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8211 Rochester Ave, Suite 101, Rancho Cucamonga, CA 91730 Phone: 909-945-2425 Fax: 909-948-6971 | |
Andrea Tieng, Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10801 Foothill Blvd Ste 106, Rancho Cucamonga, CA 91730 Phone: 909-255-7200 Fax: 909-255-7215 | |
Mihir K. Sanghvi, M.d., Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5155 Seagreen Ct, Rancho Cucamonga, CA 91739 Phone: 951-323-5598 | |
Deepak Thiagarajan, A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7974 Haven Ave Ste 210, Rancho Cucamonga, CA 91730 Phone: 909-881-5994 | |
Prowellness Healthcare Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8439 White Oak Ave Ste 1038439, Rancho Cucamonga, CA 91730 Phone: 818-532-2222 Fax: 818-591-7322 |