Provider Demographics
NPI:1295772531
Name:CHAPMAN CONVALESCENT HOSPITAL
Entity type:Organization
Organization Name:CHAPMAN CONVALESCENT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:BEEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-683-7111
Mailing Address - Street 1:4301 CAROLINE CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2902
Mailing Address - Country:US
Mailing Address - Phone:951-683-7111
Mailing Address - Fax:951-683-6826
Practice Address - Street 1:4301 CAROLINE CT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2902
Practice Address - Country:US
Practice Address - Phone:951-683-7111
Practice Address - Fax:951-683-6826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA250000124313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHPC01643FMedicaid
CAZZT05584FMedicaid
CA051643Medicare Oscar/Certification
CA555331Medicare Oscar/Certification