Provider Demographics
NPI:1679802706
Name:CHAPMAN, ELIZABETH ANN (RDHBS, RDHAP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:RDHBS, RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 MERRILL ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6855
Mailing Address - Country:US
Mailing Address - Phone:310-292-9404
Mailing Address - Fax:888-544-7106
Practice Address - Street 1:4708 MERRILL ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6855
Practice Address - Country:US
Practice Address - Phone:310-292-9404
Practice Address - Fax:888-544-7106
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-20
Last Update Date:2009-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19963124Q00000X
CA276124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist