Provider Demographics
NPI:1407954902
Name:CHOW, CHRISTINA CHANG-LYN (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:CHANG-LYN
Last Name:CHOW
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:TANGUAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 393
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94302-0393
Mailing Address - Country:US
Mailing Address - Phone:510-936-1804
Mailing Address - Fax:
Practice Address - Street 1:3081 TEAGARDEN ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-5720
Practice Address - Country:US
Practice Address - Phone:510-347-4620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7929208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H92376Medicare UPIN