Provider Demographics
NPI:1821377607
Name:CHOW, DANIEL JUSTIN (CRNA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JUSTIN
Last Name:CHOW
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 N TATUM BLVD STE 102718
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6055
Mailing Address - Country:US
Mailing Address - Phone:602-935-5884
Mailing Address - Fax:215-273-9063
Practice Address - Street 1:10810 N TATUM BLVD STE 102718
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6055
Practice Address - Country:US
Practice Address - Phone:602-935-5884
Practice Address - Fax:215-273-9063
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 178027-7367500000X
AZCRNA0790367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered