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General NPI Number Information
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NPI Number | 1033921663
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Entity Type | Organization
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Legal Business Name | JOE P CHAUVAPUN MD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 327 E PALMDALE BLVD STE D
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City | PALMDALE
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State | CA
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Zip | 93550-7139
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Country | US
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Telephone | 310-953-5502
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Fax |
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Provider Business Mailing Address
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Address Line | 327 E PALMDALE BLVD STE D
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City | PALMDALE
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State | CA
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Zip | 93550-7139
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Country | US
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Telephone | 109-535-5023
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOE POTCHANARD CHAUVAPUN
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Credential | M.D.
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Telephone | 213-375-5737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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