Provider Demographics
NPI:1770253718
Name:CHOW, JESSICA MUY (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MUY
Last Name:CHOW
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-2308
Mailing Address - Country:US
Mailing Address - Phone:626-677-0542
Mailing Address - Fax:
Practice Address - Street 1:954 W FOOTHILL BLVD STE D
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3782
Practice Address - Country:US
Practice Address - Phone:909-946-5512
Practice Address - Fax:909-946-6512
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84377183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist