Healthcare Provider Details

I. General information

NPI: 1326386590
Provider Name (Legal Business Name): ALBERT W. CHOW, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 01/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DANIEL BURNHAM CT STE 368C
SAN FRANCISCO CA
94109-0470
US

IV. Provider business mailing address

1 DANIEL BURNHAM CT STE 368C
SAN FRANCISCO CA
94109-0470
US

V. Phone/Fax

Practice location:
  • Phone: 415-441-1888
  • Fax: 415-441-9587
Mailing address:
  • Phone: 415-441-1888
  • Fax: 415-441-9587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberG69377
License Number StateCA

VIII. Authorized Official

Name: MRS. DEBRA ANN HAUB
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 415-441-1888