Provider Demographics
NPI:1902428113
Name:CHOW, DARRYL JACK (MD)
Entity type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:JACK
Last Name:CHOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 BROADWAY, FL 5
Mailing Address - Street 2:SUITE 501
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2821
Mailing Address - Country:US
Mailing Address - Phone:510-752-1244
Mailing Address - Fax:
Practice Address - Street 1:3701 BROADWAY, 5TH FLOOR
Practice Address - Street 2:SUITE 501
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611
Practice Address - Country:US
Practice Address - Phone:510-752-1244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA192993208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation