Basic Information
| Provider Information | |||||||||
| NPI: | 1386173441 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAPMAN | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6399 SAN IGNACIO AVE STE 120 | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951191215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5172425900 | ||||||||
| FaxNumber: | 4089047730 | ||||||||
| Practice Location | |||||||||
| Address1: | 99 N LA CIENEGA BLVD STE 202 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902112285 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103853300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2017 | ||||||||
| LastUpdateDate: | 03/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | A171957 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.