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NPI Code Detail

MEDICARE: MRS. DESIREE CHIPMAN PHARM.D

MEDICARE:  MRS. DESIREE  CHIPMAN  PHARM.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist58874CA

General Provider Information

NPI Number : 1114200367
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DESIREE CHIPMAN PHARM.D
Provider Business Mailing Address
First Line : 678 N WILSON WAY
Second Line :
City : STOCKTON
State : CA
Zip : 95205-4272
Country : US
Telephone Number : 209-467-7861
Fax Number : 209-467-0539
Provider Business Practice Location Address
First Line : 678 N WILSON WAY
Second Line :
City : STOCKTON
State : CA
Zip : 95205-4272
Country : US
Telephone Number : 209-467-7861
Fax Number : 209-467-0539
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2011
Last Update Date : 09/23/2011

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Directions to “ MRS. DESIREE CHIPMAN PHARM.D” Practice Location

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