MEDICARE: HUBERT W CHOW MD INC

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
1	261QP2300X	Primary Care Clinic/Center
2	261QP2300X	Primary Care Clinic/Center	G45435	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750475372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUBERT W CHOW MD INC

Provider Business Mailing Address
First Line	:	1111 E. LAS TUNAS DRIVE
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776
Country	:	US
Telephone Number	:	626-286-8473
Fax Number	:	626-286-4181

Provider Business Practice Location Address
First Line	:	1111 E. LAS TUNAS DRIVE
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776
Country	:	US
Telephone Number	:	626-286-8473
Fax Number	:	626-286-4181

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. HUBERT WING CHOW
Credential	:	M.D.
Telephone Number	:	626-286-8473

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	01/10/2018

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