NPI 1639460066
Champion Medical Group, a Medical Corporation
Practice location
- Address
- 1902 Royalty Dr STE 290, Pomona, CA 91767-3030
- Phone
- (909) 397-9007
- Mailing address
- 2980 N Beverly Glen Cir Suite 100, Los Angeles, CA 90077-1726
Authorised official
- Name
- Herbert Marshak
- Title
- Medical Liaison
- Phone
- (310) 474-9809
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1639460066
- Entity type
- Organization
- NPI issued
- 19 Apr 2011
- Record last updated
- 5 Oct 2015
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.