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General NPI Number Information
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NPI Number | 1669835773
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Entity Type | Individual
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Provider Name | JESSICA LI-YAN CHOW
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Gender | Female
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 1250 16TH ST
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City | SANTA MONICA
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State | CA
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Zip | 90404-1249
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Country | US
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Telephone | 310-794-0585
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 GLENDON AVE STE 1200
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City | LOS ANGELES
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State | CA
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Zip | 90024-3516
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | A155117
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A155117
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License Number State | CA
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