Healthcare Provider Details

I. General information

NPI: 1194722611
Provider Name (Legal Business Name): STANLEY K CHOU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3851 KATELLA AVE SUITE 301
LOS ALAMITOS CA
90720-3309
US

IV. Provider business mailing address

3851 KATELLA AVE SUITE 301
LOS ALAMITOS CA
90720-3309
US

V. Phone/Fax

Practice location:
  • Phone: 562-799-3888
  • Fax: 562-799-3880
Mailing address:
  • Phone: 562-799-3888
  • Fax: 562-799-3880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberC52023
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberC52023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: