Individual
MR. JOE POTCHANARD CHAUVAPUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
327 E PALMDALE BLVD STE D, PALMDALE, CA 93550-7139
(310) 953-5502
Mailing address
327 E PALMDALE BLVD STE D, PALMDALE, CA 93550-7139
(310) 953-5502
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A104925
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M050376
GROUP
CA
Enumeration date
10/15/2007
Last updated
04/08/2025
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