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General NPI Number Information
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NPI Number | 1598234569
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Entity Type | Individual
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Provider Name | ROSS DEANE CHAPMAN MD
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Gender | Male
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Dates
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Enumeration Date | 11/19/2018
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Last Update Date | 02/13/2019
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Provider Practice Location Address
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Address Line | 1121 SKI RUN BLVD FL 2
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-8489
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Country | US
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Telephone | 530-448-2813
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 SKI RUN BLVD FL 2
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-8489
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Country | US
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Telephone | 530-448-2813
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G61985
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 202C00000X
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Taxonomy Name | Independent Medical Examiner Physician
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License Number | G61985
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License Number State | CA
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