Provider Demographics
NPI:1164558920
Name:CHAPMAN, WILLIAM TALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:TALBERT
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 E 8TH ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2869
Mailing Address - Country:US
Mailing Address - Phone:619-475-3870
Mailing Address - Fax:619-475-6402
Practice Address - Street 1:2340 E 8TH ST
Practice Address - Street 2:SUITE G
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2869
Practice Address - Country:US
Practice Address - Phone:619-475-3870
Practice Address - Fax:619-475-6402
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38997174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G389970Medicaid
CAG38997Medicare ID - Type Unspecified
CAA89675Medicare UPIN