CHINO MEDICAL GROUP, INC (NPI# 1053350884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053350884 |
| Entity Type | Organization |
| Organization Name | CHINO MEDICAL GROUP, INC |
| Practice Address |
5475 Walnut Ave Chino CA 91710-2609 |
| Practice Telephone | 9095916446 |
| Practice Fax Number | 9095911309 |
| Mailing Telephone | 9095916446 |
| Mailing Fax Number | 9095911309 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOSE ALEX LIRA (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9095916446 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities | ||
| X | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790730786 | Chino Medical Group, Inc | Internal Medicine | 5475 Walnut Ave, Chino, CA 91710-2609 | 2006-05-24 |
| Street Address |
5475 WALNUT AVE |
| City | CHINO |
| State | CA |
| Zip Code | 91710-2609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790730786 | Chino Medical Group, Inc | Internal Medicine | 5475 Walnut Ave, Chino, CA 91710-2609 | 2006-05-24 |
| 1174914303 | Teresa Louie | Nurse Practitioner | 5475 Walnut Ave, Chino, CA 91710-2609 | 2015-02-10 |
| 1952730061 | Heather Michelle Sykes | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2013-11-08 |
| 1912217977 | Desiree Renee Bonomo | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2010-10-08 |
| 1649419482 | Andrew Alfred Harris | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2009-02-18 |
| 1689829327 | Miguel Angel Cervantes-lopez | Family Medicine | 5475 Walnut Ave, Chino, CA 91710-2609 | 2008-11-21 |
| 1679724231 | Prakob Sen Sok | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2008-10-01 |
| 1417003930 | Subash Chander | Family Medicine | 5475 Walnut Ave, Chino, CA 91710-2609 | 2007-01-26 |
| 1194753426 | Stephen Anthony Harvey | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2006-06-28 |
| 1821038985 | Jose Alejandro Lira | Internal Medicine | 5475 Walnut Ave, Chino, CA 91710-2609 | 2006-06-07 |
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|---|---|---|---|---|
| 1962037887 | Corrections and Rehabilitation | Pharmacy | 14901 So Central Avenue, Chino, CA 91710 | 2020-03-11 |
| 1053968289 | California Institute for Men Phcy | Pharmacy | 14901 So Central Ave, Chino, CA 91710 | 2019-08-22 |
| 1982170510 | Kind Care Connections, LLC | In Home Supportive Care | 14726 Ramona Ave # E10, Chino, CA 91710 | 2018-10-22 |
| 1922593789 | Christopher Armando Camarena | Assistant Behavior Analyst | 6062 Eucalyptus Ave, Chino, CA 91710 | 2018-06-25 |
| 1730696519 | Barsoum Dental Corp | Dentist | 14613 Ramona Ave, Chino, CA 91710 | 2018-01-03 |
| 1326569864 | Christina La | Optometrist | 5250 Philadelphia St Ste D, Chino, CA 91710 | 2017-07-06 |
| 1629502554 | Jk Pharmacy Inc | Pharmacy | 5562 Philadelphia St, #110, Chino, CA 91710 | 2017-04-18 |
| 1801336680 | Altek Drugs Inc. | Pharmacy | 13085 Central Ave Ste 2, Chino, CA 91710 | 2017-02-28 |
| 1518405893 | Audrey Ronquillo | Behavior Technician | 800 Ferrari Ln, Suite 100, Ontario, CA 91710 | 2017-02-07 |
| 1952849556 | Jennifer Huynh | Behavior Technician | 800 Ferrari Ln Suite 100, Ontario, CA 91710 | 2017-02-03 |
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| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457820466 | Chino Premier Surgery Center Limited Partnership | Clinic/Center | 5562 Philadelphia St Ste 111, Chino, CA 91710-2482 | 2018-11-19 |
| 1104150580 | Genesis Healthcare System | Clinic/Center | 11760 Central Ave Ste 125, Chino, CA 91710-1909 | 2009-10-01 |
| 1952493124 | Maximum Surgery Medical Center, Inc. | Clinic/Center | 11760 Central Ave, Suite 204, Chino, CA 91710-1900 | 2006-09-28 |
| 1023651445 | Chino Vascular & Surgery Center Inc | Clinic/Center | 11760 Central Ave Ste 204, Chino, CA 91710-1909 | 2019-10-18 |
| 1154795730 | Guanyin Surgery Center,inc | Clinic/Center | 11760 Central Ave, Suite 204, Chino, CA 91710-1900 | 2015-11-19 |
| 1841604972 | Spectrum Pain Management Center | Clinic/Center | 14365 Pipeline Ave, Chino, CA 91710-5642 | 2014-06-17 |
| 1568749877 | Central Outpatient Surgery Center.inc | Clinic/Center | 11760 Central Ave, Suite 204, Chino, CA 91710-1900 | 2011-11-15 |
| 1558515015 | Genesis Surgical Center | Clinic/Center | 11760 Central Ave Ste 204, Chino, CA 91710-1909 | 2008-11-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.