Basic Information
| Provider Information | |||||||||
| NPI: | 1477743300 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHOW | ||||||||
| FirstName: | DENISE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | UCLA 200 MEDICAL CENTER PLZ | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900950001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107940206 | ||||||||
| FaxNumber: | 3107940211 | ||||||||
| Practice Location | |||||||||
| Address1: | UCLA 200 MEDICAL CENTER PLZ | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900950001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107940206 | ||||||||
| FaxNumber: | 3107940211 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2007 | ||||||||
| LastUpdateDate: | 12/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 261447 | CA | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 1077232 | 05 | LA | MEDICAID | 1477743300 | 05 | CA | MEDICAID |