NPIMap

Individual provider Active NPI

David Alan Chamberlin, MD

  • Urology Physician
  • Orange, CA
National Provider Identifier
1205861994
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G68017 Issued in CA
Practice address
725 W la Veta Ave
#220
Orange, CA 92868-4403
Phone
(714) 639-3134
Fax
(714) 639-6974
NPI assigned
Jul 11, 2006
Last updated
Apr 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X G68017 CA Primary

Addresses

Primary practice location

725 W la Veta Ave
#220
Orange, CA 92868-4403

Mailing address

725 W la Veta Ave
#220
Orange, CA 92868-4403
Phone (714) 639-3134

Other identifiers 1

IdentifierTypeStateIssuer
GR0029120MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040301000874 CA Practitioner - UrologyPractitioner - Pediatric Medicine 0840187209 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Urology CurrentSince Aug 5, 2012 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Children's Urology, Inc Urology Past Accepting new patients
University of California Irvine Past Accepting new patients
Children's Hospital of Orange County Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dchamberlin5884@direct.llu.edu

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1205861994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 W LA VETA AVE",
            "address_2": "#220",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684403",
            "telephone_number": "714-639-3134",
            "fax_number": "714-639-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W LA VETA AVE",
            "address_2": "#220",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684403",
            "telephone_number": "714-639-3134",
            "fax_number": "714-639-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLIN",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G68017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0029120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.