Provider Demographics
NPI:1194722611
Name:CHOU, STANLEY K (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:K
Last Name:CHOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3851 KATELLA AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3309
Mailing Address - Country:US
Mailing Address - Phone:562-799-3888
Mailing Address - Fax:562-799-3880
Practice Address - Street 1:3851 KATELLA AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3309
Practice Address - Country:US
Practice Address - Phone:562-799-3888
Practice Address - Fax:562-799-3880
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52023207LP2900X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6155901Medicaid
NJ6155901Medicaid
CAAS277Medicare PIN
NJ430877Medicare PIN