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General NPI Number Information
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NPI Number | 1801046867
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Entity Type | Individual
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Provider Name | CHAIYAPORN BOONCHALERMVICHIAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 11480 BROOKSHIRE AVE SUITE 309
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City | DOWNEY
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State | CA
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Zip | 90241-5018
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Country | US
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Telephone | 562-869-1201
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Fax | 562-869-1281
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Provider Business Mailing Address
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Address Line | 18000 STUDEBAKER RD STE 800
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City | CERRITOS
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State | CA
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Zip | 90703-2671
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Country | US
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Telephone | 562-735-3226
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Fax | 562-869-1281
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 01098101A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 01098101A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 2008014384
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 01098101A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01098101A
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A112439
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License Number State | CA
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