Provider Demographics
NPI:1043293509
Name:CHAPMAN, RACHEL L (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:L
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 W SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6062
Mailing Address - Country:US
Mailing Address - Phone:323-361-5939
Mailing Address - Fax:323-361-7927
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-5939
Practice Address - Fax:323-361-7927
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066399208000000X, 2080N0001X
CT0394882080N0001X
CAC1277652080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001394882Medicaid
CT001394882Medicaid
MIG93762Medicare UPIN
CT370001369Medicare ID - Type Unspecified