Healthcare Provider Details

I. General information

NPI: 1740350362
Provider Name (Legal Business Name): DAVID CHIPMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6552 BOLSA AVE STE. A
HUNTINGTON BEACH CA
92647-2622
US

IV. Provider business mailing address

15702 BLUEBIRD LN
HUNTINGTON BEACH CA
92649-1403
US

V. Phone/Fax

Practice location:
  • Phone: 714-898-0515
  • Fax:
Mailing address:
  • Phone: 714-375-5521
  • Fax: 714-373-5972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC19410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: