Provider Demographics
NPI:1609104975
Name:WILLIAM E CHAPMAN III M D A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:WILLIAM E CHAPMAN III M D A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:650-494-1683
Mailing Address - Street 1:3583 LOUIS RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4406
Mailing Address - Country:US
Mailing Address - Phone:650-494-1683
Mailing Address - Fax:650-813-1239
Practice Address - Street 1:3583 LOUIS RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4406
Practice Address - Country:US
Practice Address - Phone:650-494-1683
Practice Address - Fax:650-813-1239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1922022433Medicare PIN