Provider Demographics
NPI:1992094254
Name:CHOW, IRWIN DAVID JR (PHARMD)
Entity type:Individual
Prefix:
First Name:IRWIN
Middle Name:DAVID
Last Name:CHOW
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4974 N FRESNO ST # PMB243
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-0317
Mailing Address - Country:US
Mailing Address - Phone:559-355-0672
Mailing Address - Fax:
Practice Address - Street 1:4974 N FRESNO ST # PMB243
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0317
Practice Address - Country:US
Practice Address - Phone:559-355-0672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2015-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH26585183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist