Provider Demographics
NPI:1710107123
Name:TIVAKARAN AND CHOW GASTROENTEROLOGY
Entity Type:Organization
Organization Name:TIVAKARAN AND CHOW GASTROENTEROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HSICHAO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-451-9999
Mailing Address - Street 1:3939 J STREET
Mailing Address - Street 2:300
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819
Mailing Address - Country:US
Mailing Address - Phone:916-451-9999
Mailing Address - Fax:916-451-2672
Practice Address - Street 1:3939 J STREET
Practice Address - Street 2:300
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819
Practice Address - Country:US
Practice Address - Phone:916-451-9999
Practice Address - Fax:916-451-2672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50769207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0065320Medicaid
CAZZZ00484ZMedicare ID - Type Unspecified
CAA29285Medicare UPIN
CAGR0065320Medicaid
CAA49596Medicare UPIN