Provider Demographics
NPI:1669096236
Name:CHOU, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:CHOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:CHOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1451 N RICHMAN KNLS
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3611
Mailing Address - Country:US
Mailing Address - Phone:408-888-8692
Mailing Address - Fax:
Practice Address - Street 1:6112 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2306
Practice Address - Country:US
Practice Address - Phone:408-888-8692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107570122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist