Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | G86048 | CA |
N | 2080P0208X | Pediatric Infectious Diseases | G86048 | CA |
NPI | 1295864866 |
---|---|
Provider Name | Emilie L Chow |
First Address | Los Angeles, CA 90051-3620 |
Second Address | Orange, CA 92868-3201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G860480 | (05) | CA |
BC8631586 | DEA (01) | CA |
H08110 | (02) | CA |