Provider Demographics
NPI:1932573409
Name:JOSEPH CHAMMAS MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JOSEPH CHAMMAS MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHAMMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-425-2737
Mailing Address - Street 1:13242 ENTREKEN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2304
Mailing Address - Country:US
Mailing Address - Phone:619-425-2737
Mailing Address - Fax:619-425-5869
Practice Address - Street 1:13242 ENTREKEN AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2304
Practice Address - Country:US
Practice Address - Phone:619-425-2737
Practice Address - Fax:619-425-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-21
Last Update Date:2015-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG86116OtherMEDICAL LICENSE