Provider Demographics
NPI:1932122413
Name:CHOW, GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:CHOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:#107
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2813
Mailing Address - Country:US
Mailing Address - Phone:818-996-3880
Mailing Address - Fax:818-996-1679
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:#107
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2813
Practice Address - Country:US
Practice Address - Phone:818-996-3880
Practice Address - Fax:818-996-1679
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG578622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G578620Medicaid
CAWG57862GOtherMEDICARE PIN UCLA
CAWG57862EMedicare PIN
CAE87678Medicare UPIN