Provider Demographics
NPI:1073658530
Name:CHO, HYUN MYUNG (MD)
Entity Type:Individual
Prefix:
First Name:HYUN
Middle Name:MYUNG
Last Name:CHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:HYUN
Other - Last Name:CHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:41990 COOK ST STE 1001
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6105
Mailing Address - Country:US
Mailing Address - Phone:760-360-0033
Mailing Address - Fax:760-360-0220
Practice Address - Street 1:41990 COOK ST STE 1001
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6105
Practice Address - Country:US
Practice Address - Phone:760-360-0033
Practice Address - Fax:760-360-0220
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A680180Medicare ID - Type Unspecified
CAH02660Medicare UPIN