Provider Demographics
NPI:1104668714
Name:CHASAR, CAULON K
Entity type:Individual
Prefix:
First Name:CAULON
Middle Name:K
Last Name:CHASAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 PAN AMERICAN FWY NE APT 101
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4762
Mailing Address - Country:US
Mailing Address - Phone:216-856-0338
Mailing Address - Fax:
Practice Address - Street 1:1860 E 31ST ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-1810
Practice Address - Country:US
Practice Address - Phone:216-856-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant