Provider Demographics
NPI:1104249200
Name:CHOU, KOWEI (LAC)
Entity type:Individual
Prefix:MR
First Name:KOWEI
Middle Name:
Last Name:CHOU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:JAX
Other - Middle Name:
Other - Last Name:CHOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:552 RYAN TER
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1535
Mailing Address - Country:US
Mailing Address - Phone:408-505-1168
Mailing Address - Fax:
Practice Address - Street 1:552 RYAN TER
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1535
Practice Address - Country:US
Practice Address - Phone:408-505-1168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15850171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist