Healthcare Provider Details

I. General information

NPI: 1235666876
Provider Name (Legal Business Name): VINCENT CHOU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2017
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL MEDICAL CENTER 34800 BOB HOPE DR
SAN DIEGO CA
92134-0001
US

IV. Provider business mailing address

NAVAL MEDICAL CENTER 34800 BOB HOPE DR
SAN DIEGO CA
92134-0001
US

V. Phone/Fax

Practice location:
  • Phone: 619-916-1401
  • Fax: 619-532-8353
Mailing address:
  • Phone: 619-532-5998
  • Fax: 619-532-5507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: