Provider Demographics
NPI:1033921663
Name:JOE P CHAUVAPUN MD PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JOE P CHAUVAPUN MD PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:POTCHANARD
Authorized Official - Last Name:CHAUVAPUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-375-5737
Mailing Address - Street 1:327 E PALMDALE BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-7139
Mailing Address - Country:US
Mailing Address - Phone:109-535-5023
Mailing Address - Fax:
Practice Address - Street 1:327 E PALMDALE BLVD STE D
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-7139
Practice Address - Country:US
Practice Address - Phone:310-953-5502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty