Provider Demographics
NPI:1477874121
Name:CHOU, JEAN
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:
Last Name:CHOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 S FLICKER CT
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4418
Mailing Address - Country:US
Mailing Address - Phone:714-306-1952
Mailing Address - Fax:
Practice Address - Street 1:5560 E SANTA ANA CANYON RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3124
Practice Address - Country:US
Practice Address - Phone:714-998-4801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35100022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist