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General NPI Number Information
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NPI Number | 1063762276
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Entity Type | Organization
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Legal Business Name | RANDALL H CHAPMAN MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 1615 HILL RD SUITE #8
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City | NOVATO
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State | CA
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Zip | 94947-4340
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Country | US
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Telephone | 415-897-1022
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Fax |
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Provider Business Mailing Address
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Address Line | 1615 HILL RD SUITE #8
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City | NOVATO
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State | CA
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Zip | 94947-4340
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Country | US
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Telephone | 415-897-1022
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | OLIVIA GONZALEZ
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Credential |
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Telephone | 415-897-1022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A294500
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License Number State | CA
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