Provider Demographics
NPI:1891707618
Name:LACHAPELLE, BRIAN KEITH (PA)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:KEITH
Last Name:LACHAPELLE
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:4140 W 190TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18133 VENTURA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3645
Practice Address - Country:US
Practice Address - Phone:310-423-8888
Practice Address - Fax:310-423-8880
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA56781363AS0400X, 363AS0400X
IDPA-1059363AS0400X
COPA.0006837363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical