Healthcare Provider Details

I. General information

NPI: 1114741717
Provider Name (Legal Business Name): CHRISTOPHER CHAPMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 LOMITA BLVD
TORRANCE CA
90505-5002
US

IV. Provider business mailing address

8101 N 107TH AVE UNIT 36
PEORIA AZ
85345-7555
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-9110
  • Fax:
Mailing address:
  • Phone: 623-336-9383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number179624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: