Provider Demographics
NPI:1366735672
Name:CHAPMAN, BART (MD)
Entity type:Individual
Prefix:DR
First Name:BART
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3257 CAMINO DE LOS COCHES STE 305
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8974
Mailing Address - Country:US
Mailing Address - Phone:760-436-6333
Mailing Address - Fax:
Practice Address - Street 1:3257 CAMINO DE LOS COCHES STE 305
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8974
Practice Address - Country:US
Practice Address - Phone:760-436-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37946174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator