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NPI Code Detail

MEDICARE: BRUCE CHOW DO

MEDICARE: BRUCE CHOW DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician20A7057CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10020A70570OTHERCAMEDI CAL #

General Provider Information

NPI Number : 1013913441
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE CHOW DO
Provider Business Mailing Address
First Line : 817 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90005-1522
Country : US
Telephone Number : 213-385-0029
Fax Number :
Provider Business Practice Location Address
First Line : 817 S VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90005-1522
Country : US
Telephone Number : 213-385-0029
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 05/04/2016

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Directions to “ BRUCE CHOW DO” Practice Location

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