Healthcare Provider Details

I. General information

NPI: 1629395801
Provider Name (Legal Business Name): LIN-CHIANG PHILIP CHOU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

2335 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7450
  • Fax:
Mailing address:
  • Phone: 916-734-7450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA148271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: