CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION (NPI# 1639460066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639460066 |
Entity Type | Organization |
Organization Name | CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION |
Practice Address |
1902 Royalty Dr Ste 290 Pomona CA 91767-3030 |
Mailing Address |
2980 N Beverly Glen Cir Suite 100 Los Angeles CA 90077-1726 |
Practice Telephone | 9093979007 |
Mailing Telephone | 3104749809 |
Mailing Fax Number | 8884318819 |
Enumeration Date | 2011-04-19 |
Last Update Date | 2015-10-05 |
Authorized Official Name | HERBERT MARSHAK (MEDICAL LIAISON) |
Authorized Official Telephone | 3104749809 |
Authorized Official Credential | MD |
Is Organization Subpart | Y |
Parent Organization Name | CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144525775 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 3211 Van Buren Blvd Ste B, Riverside, CA 92503-5640 | 2011-01-12 |
1386935716 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 1206 E 17th St, Ste 106, Santa Ana, CA 92701-2641 | 2011-04-19 |
1417248840 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 8121 Van Nuys Blvd, Ste 316, Panorama City, CA 91402-5105 | 2011-04-19 |
1871884205 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 1711 W Temple St, Ste 4100, Los Angeles, CA 90026-5421 | 2011-04-19 |
1164713590 | Champion Medical Group, A Medical Corporation | Non-Pharmacy Dispensing Site | 2777 Pacific Ave, Ste K, Long Beach, CA 90806-2625 | 2011-04-19 |
Street Address |
1902 ROYALTY DR STE 290 |
City | POMONA |
State | CA |
Zip Code | 91767-3030 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629073804 | Samuel Salen | Radiology | 1902 Royalty Dr, Ste 220, Pomona, CA 91767-3056 | 2005-06-15 |
1447721972 | Sarina Karwande | Physical Medicine & Rehabilitation | 1902 Royalty Dr, Pomona, CA 91767-3030 | 2018-12-10 |
1740778810 | Diana Marissa Velasco | Physical Therapy Assistant | 1902 Royalty Dr, Pomona, CA 91767-3030 | 2018-04-24 |
1902323181 | Justin Shieh | Occupational Therapist | 1902 Royalty Dr, Pomona, CA 91767-3030 | 2017-08-28 |
1609271501 | Maria Sancho | Physical Therapist | 1902 Royalty Dr, Suite 170, Pomona, CA 91767-3030 | 2014-11-04 |
1144636473 | Samantha Cardeno | Physical Therapist | 1902 Royalty Dr, Suite 170, Pomona, CA 91767-3030 | 2014-07-08 |
1083963664 | Casey Mccollum | Physician Assistant | 1902 Royalty Dr, Suite 130, Pomona, CA 91767-3030 | 2012-08-29 |
1861767212 | Stuart L Zubrick Marriage Family and Child Counseling, A Prof Corp | Non-Pharmacy Dispensing Site | 1902 Royalty Dr, Ste 290, Pomona, CA 91767-3030 | 2012-03-19 |
1063797835 | Rochelle Rose Gunnarsson | Physical Therapist | 1902 Royalty Dr, Suite 220, Pomona, CA 91767-3030 | 2011-10-12 |
1245511633 | Arj Medical Inc. | Non-Pharmacy Dispensing Site | 1902 Royalty Dr, Suite 120, Pomona, CA 91767-3030 | 2011-08-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942807979 | Ayed Hawatmeh Dds Inc | Dentist | 322 E Foothill Blvd, Pomona, CA 91767 | 2020-10-02 |
1780205302 | Melanie Crystal Ramirez | Counselor | 845 East Arrow Hwy, Pomona, CA 91767 | 2020-05-05 |
1780249029 | Jean Hang | Pharmacist | 775 East Foothill Blvd, Pomona, CA 91767 | 2019-05-02 |
1679043269 | Christy Bloss | Counselor | 16029 Arrow Hwy. Suite G, Irwindale, CA 91767 | 2018-11-27 |
1740758895 | Pomona Community Health Center | Dentist | 1448 E Holt Avenue, Pomona, CA 91767 | 2018-11-07 |
1245749878 | Continental Post Acute LLC | Skilled Nursing Facility | 1912 N.san Antonio, Pomona, CA 91767 | 2017-09-26 |
1083134373 | Virginia Thompson | Counselor | 845 E. Arrow Hwy., Pomona, CA 91767 | 2017-06-27 |
1215489000 | Boys Republic - Pomona Residence | Community/Behavioral Health | 733 N Garey Ave, Pomona, CA 91767 | 2016-10-27 |
1164870499 | Karthikeyan Bhuvaneswaran | Psychiatry & Neurology | 255 E Bonita Ave Bldg Suite103, Pomona, CA 91767 | 2016-05-26 |
1679936777 | Nex's Traditional Chinese Medicine | Acupuncturist | 1150 N Garey Ave, Pomona, CA 91767 | 2016-04-05 |
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Taxonomy Code | 332900000X |
Grouping | Suppliers |
Classification | Non-Pharmacy Dispensing Site |
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013321132 | Arj Medical, Inc. | Non-Pharmacy Dispensing Site | 724 Corporate Center Dr, Pomona, CA 91768-2655 | 2014-06-17 |
1760860894 | Joseph M Molina Md Professional Corporation Southern Ca | Non-Pharmacy Dispensing Site | 887 E 2nd St, Pomona, CA 91766-2009 | 2015-05-08 |
1861767212 | Stuart L Zubrick Marriage Family and Child Counseling, A Prof Corp | Non-Pharmacy Dispensing Site | 1902 Royalty Dr, Ste 290, Pomona, CA 91767-3030 | 2012-03-19 |
1245511633 | Arj Medical Inc. | Non-Pharmacy Dispensing Site | 1902 Royalty Dr, Suite 120, Pomona, CA 91767-3030 | 2011-08-30 |
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1982225496 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 5757 Pacific Ave Ste 228, Stockton, CA 95207-5159 | 2020-05-06 |
1285268391 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 1337 S Lovers Ln Ste D, Visalia, CA 93292-5249 | 2020-02-27 |
1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
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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.