Provider Demographics
NPI:1821267162
Name:DAVID A CHAPPELL MD, MEDICAL CORPORATION
Entity Type:Organization
Organization Name:DAVID A CHAPPELL MD, MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-762-0001
Mailing Address - Street 1:141 LYNCH CREEK WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-2341
Mailing Address - Country:US
Mailing Address - Phone:707-762-0001
Mailing Address - Fax:707-765-0666
Practice Address - Street 1:141 LYNCH CREEK WAY
Practice Address - Street 2:SUITE A
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-2341
Practice Address - Country:US
Practice Address - Phone:707-762-0001
Practice Address - Fax:707-765-0666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40326207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty