Basic Information
Provider Information
NPI: 1487001590
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOU
FirstName: BENJAMIN
MiddleName: F
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4955 VAN NUYS BLVD STE 308
Address2:  
City: SHERMAN OAKS
State: CA
PostalCode: 914031811
CountryCode: US
TelephoneNumber: 8185281044
FaxNumber:  
Practice Location
Address1: 3033 W ORANGE AVE
Address2:  
City: ANAHEIM
State: CA
PostalCode: 928043183
CountryCode: US
TelephoneNumber: 7148273000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2016
LastUpdateDate: 09/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000XA161900CAY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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