Provider Demographics
NPI:1477743300
Name:CHOW, DENISE (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:CHOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UCLA 200 MEDICAL CENTER PLZ
Mailing Address - Street 2:SUITE 140
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-794-0206
Mailing Address - Fax:310-794-0211
Practice Address - Street 1:UCLA 200 MEDICAL CENTER PLZ
Practice Address - Street 2:SUITE 140
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-794-0206
Practice Address - Fax:310-794-0211
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261447208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1077232Medicaid
CA1477743300Medicaid
CAFH549ZMedicare PIN