Individual provider Active NPI

Thick GW Chow, MD

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1447282876
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A29113 Issued in CA
Practice address
817 South Vermont Avenue
Los Angeles, CA 90005-1522
Phone
(213) 385-0029
Fax
(213) 385-5619
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A29113 CA Primary

Addresses

Primary practice location

817 South Vermont Avenue
Los Angeles, CA 90005-1522

Mailing address

817 South Vermont Avenue
Los Angeles, CA 90005-1522
Phone (213) 385-0029

Other identifiers 1

IdentifierTypeStateIssuer
00A291130MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091112000158 CA Practitioner - Family Practice 3274601588 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A29113CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chow Medical Clinic, Inc. Family Medicine CurrentSince Dec 7, 2016 Accepting new patients

Locations

817 S Vermont Ave
Los Angeles, CA 90005
Phone (213) 385-0029

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447282876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 SOUTH VERMONT AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051522",
            "telephone_number": "213-385-0029",
            "fax_number": "213-385-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 SOUTH VERMONT AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051522",
            "telephone_number": "213-385-0029",
            "fax_number": "213-385-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOW",
        "first_name": "THICK",
        "middle_name": "GW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A29113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A291130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.