Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | SL2938 | CA |
NPI | 1184836835 |
---|---|
Provider Name | Victor Chapman |
First Address | Vacaville, CA 95687-7772 |
Second Address | Davis, CA 95616-4623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 11/07/2016 |