Provider Demographics
NPI:1326175944
Name:CHAPMAN, CHAD RANDALL (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:RANDALL
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2564 STATE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1662
Mailing Address - Country:US
Mailing Address - Phone:760-434-8134
Mailing Address - Fax:760-434-3370
Practice Address - Street 1:2564 STATE ST
Practice Address - Street 2:STE. A
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1662
Practice Address - Country:US
Practice Address - Phone:760-434-8134
Practice Address - Fax:760-434-3370
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor