Provider Demographics
NPI:1215045588
Name:CHOW, CHIN CHUN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHIN
Middle Name:CHUN
Last Name:CHOW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 S BREA BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5308
Mailing Address - Country:US
Mailing Address - Phone:714-255-8389
Mailing Address - Fax:714-255-8599
Practice Address - Street 1:633 S BREA BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5308
Practice Address - Country:US
Practice Address - Phone:714-255-8389
Practice Address - Fax:714-255-8599
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24853OtherCHIROPRACTIC LICENSE
CADC24853OtherCHIROPRACTIC LICENSE