Provider Demographics
NPI:1700082179
Name:WILLIAM CHOW DO
Entity Type:Organization
Organization Name:WILLIAM CHOW DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:510-895-0510
Mailing Address - Street 1:13851 E 14TH ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2631
Mailing Address - Country:US
Mailing Address - Phone:510-895-0510
Mailing Address - Fax:510-895-5887
Practice Address - Street 1:13851 E 14TH ST
Practice Address - Street 2:SUITE 308
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2631
Practice Address - Country:US
Practice Address - Phone:510-895-0510
Practice Address - Fax:510-895-5887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4862261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE08823Medicare UPIN
CA020A48620Medicare ID - Type Unspecified