Healthcare Provider Details

I. General information

NPI: 1669798021
Provider Name (Legal Business Name): LUCIA YUN CHOU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2010
Last Update Date: 11/07/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 BROADWAY
OAKLAND CA
94611-5730
US

IV. Provider business mailing address

115 RONADA AVE
PIEDMONT CA
94611-3911
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-1000
  • Fax:
Mailing address:
  • Phone: 312-550-1656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD60658819
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC197609
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberMD60658819
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: