Provider Demographics
NPI:1093950818
Name:THEODORE CHOW MD INC
Entity Type:Organization
Organization Name:THEODORE CHOW MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACC
Authorized Official - Phone:408-240-5960
Mailing Address - Street 1:175 N JACKSON AVE
Mailing Address - Street 2:SUITE # 111
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1909
Mailing Address - Country:US
Mailing Address - Phone:408-240-5960
Mailing Address - Fax:408-240-5964
Practice Address - Street 1:175 N JACKSON AVE
Practice Address - Street 2:SUITE # 111
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1909
Practice Address - Country:US
Practice Address - Phone:408-240-5960
Practice Address - Fax:408-240-5964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH18630Medicare UPIN