Provider Demographics
NPI:1952606881
Name:CHOW, CANDACE SIN-TAO (MD)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:SIN-TAO
Last Name:CHOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9010 W CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8932
Mailing Address - Country:US
Mailing Address - Phone:702-240-8646
Mailing Address - Fax:702-932-8347
Practice Address - Street 1:9010 W CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8932
Practice Address - Country:US
Practice Address - Phone:702-240-8646
Practice Address - Fax:702-932-8347
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND11715207Q00000X
NV14164207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1952606881Medicaid
NVFZ404ZMedicare PIN
NV1952606881Medicaid