Healthcare Provider Details

I. General information

NPI: 1255225348
Provider Name (Legal Business Name): CHRISTINA CHAPMAN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 S EL CAMINO REAL STE 101
SAN MATEO CA
94402-3067
US

IV. Provider business mailing address

1528 S EL CAMINO REAL STE 101
SAN MATEO CA
94402-3067
US

V. Phone/Fax

Practice location:
  • Phone: 650-570-5955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36222TLG
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number14226553-9934
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: