Healthcare Provider Details

I. General information

NPI: 1811102817
Provider Name (Legal Business Name): THOMAS TAO-TSYR CHOU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 FOREST AVE
SAN JOSE CA
95128-1425
US

IV. Provider business mailing address

4701 OGLETOWN STANTON RD STE 4200
NEWARK DE
19713-2075
US

V. Phone/Fax

Practice location:
  • Phone: 408-947-2501
  • Fax:
Mailing address:
  • Phone: 302-737-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberC1-0023923
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: