Healthcare Provider Details

I. General information

NPI: 1629905963
Provider Name (Legal Business Name): CHAD CARMAN DO AND ASSOCIATES A CALIFORNIA MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17155 NEWHOPE ST STE Q
FOUNTAIN VALLEY CA
92708-4233
US

IV. Provider business mailing address

17155 NEWHOPE ST STE Q
FOUNTAIN VALLEY CA
92708-4233
US

V. Phone/Fax

Practice location:
  • Phone: 714-794-9844
  • Fax:
Mailing address:
  • Phone: 714-794-9844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JAYLENE NGUYEN
Title or Position: CFO & SECRETARY
Credential:
Phone: 714-794-9844