Healthcare Provider Details

I. General information

NPI: 1083793707
Provider Name (Legal Business Name): CHAPMAN AND DI REDO PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2808 PARK AVE SUITE B
MERCED CA
95348-3375
US

IV. Provider business mailing address

2808 PARK AVE SUITE B
MERCED CA
95348-3375
US

V. Phone/Fax

Practice location:
  • Phone: 209-723-8144
  • Fax: 209-723-5605
Mailing address:
  • Phone: 209-723-8144
  • Fax: 209-723-5605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number0PT299911
License Number StateCA

VIII. Authorized Official

Name: CHRISTOPHER NICOLAS DI REDO
Title or Position: PHYSICAL THERAPIST / OWNER
Credential: M.P.T.
Phone: 209-723-8144