CHAMPION MEDICAL GROUP, A MEDICAL CORPORATION


Address: 1902 Royalty Dr, Ste 290, Pomona, CA 91767-3030
Phone: 9093979007

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332900000X Non-Pharmacy Dispensing Site Suppliers

Other Provider IDs and Locations

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

Office Location

Street Address 1902 ROYALTY DR
STE 290
City POMONA
State CA
Zip Code 91767-3030

Providers in the same location

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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Providers in the same zip code

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 Information

Taxonomy Code 332900000X
Grouping Suppliers
Classification Non-Pharmacy Dispensing Site

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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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Competitor

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City POMONA
Zip Code 91767

Improve Information

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Dataset Information

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.

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