Provider Demographics
NPI:1336807288
Name:CHOW, ANDY
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:CHOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6271 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-1562
Mailing Address - Country:US
Mailing Address - Phone:626-898-4560
Mailing Address - Fax:
Practice Address - Street 1:6271 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-1562
Practice Address - Country:US
Practice Address - Phone:626-898-4560
Practice Address - Fax:626-898-4561
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017781363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily