Healthcare Provider Details

I. General information

NPI: 1073346557
Provider Name (Legal Business Name): KYUNG CHOW NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SYLVIA CHOW

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 S DOUGLAS ST FL 3
EL SEGUNDO CA
90245-4810
US

IV. Provider business mailing address

18370 BURBANK BLVD STE 204
TARZANA CA
91356-2851
US

V. Phone/Fax

Practice location:
  • Phone: 800-985-5596
  • Fax:
Mailing address:
  • Phone: 818-342-0793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95032294
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95193972
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: