Healthcare Provider Details

I. General information

NPI: 1902341142
Provider Name (Legal Business Name): STEVEN CHOW MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2016
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

886 W FOOTHILL BLVD SUITE C
UPLAND CA
91786-3769
US

IV. Provider business mailing address

1544 7TH ST 14
SANTA MONICA CA
90401-3403
US

V. Phone/Fax

Practice location:
  • Phone: 310-280-8719
  • Fax:
Mailing address:
  • Phone: 310-280-8719
  • Fax: 310-310-8144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA104395
License Number StateCA

VIII. Authorized Official

Name: DR. STEVEN CHOW
Title or Position: CEO
Credential: MD
Phone: 310-280-8719