Provider Demographics
NPI:1184836835
Name:CHAPMAN, VICTOR (RDO)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 WILD ROSE CT
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-7772
Mailing Address - Country:US
Mailing Address - Phone:707-595-2020
Mailing Address - Fax:530-758-7576
Practice Address - Street 1:718 2ND ST
Practice Address - Street 2:SUITE 3
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4623
Practice Address - Country:US
Practice Address - Phone:530-758-7571
Practice Address - Fax:530-757-0910
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL2938156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician