Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 204E00000X | CA |
NPI | 1073029617 |
---|---|
Provider Name | Dr. Rachel Christine Chapa |
First Address | Oakland, CA 94602-1342 |
Second Address | Oakland, CA 94602-1018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2017 |
Last Update Date | 19/12/2017 |