Provider Demographics
NPI:1750475372
Name:HUBERT W CHOW MD INC
Entity Type:Organization
Organization Name:HUBERT W CHOW MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HUBERT
Authorized Official - Middle Name:WING
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-286-8473
Mailing Address - Street 1:1111 E. LAS TUNAS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776
Mailing Address - Country:US
Mailing Address - Phone:626-286-8473
Mailing Address - Fax:626-286-4181
Practice Address - Street 1:1111 E. LAS TUNAS DRIVE
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776
Practice Address - Country:US
Practice Address - Phone:626-286-8473
Practice Address - Fax:626-286-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45435261QP2300X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G454350Medicaid
CAA50041Medicare UPIN
CA00G454350Medicaid