Healthcare Provider Details

I. General information

NPI: 1740276187
Provider Name (Legal Business Name): SOONG CHAPMAN AND BEYMER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 S SAN MATEO DR STE 260
SAN MATEO CA
94401
US

IV. Provider business mailing address

50 S SAN MATEO DR STE 260
SAN MATEO CA
94401
US

V. Phone/Fax

Practice location:
  • Phone: 650-579-6500
  • Fax: 650-579-1943
Mailing address:
  • Phone: 650-579-6500
  • Fax: 650-579-1943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MAUREEN A KELLY
Title or Position: GROUP PRACTICE MANAGER
Credential: MHA
Phone: 650-579-6500