Provider Demographics
NPI:1083907752
Name:CHON, CHANG-HO L (DO)
Entity Type:Individual
Prefix:
First Name:CHANG-HO
Middle Name:L
Last Name:CHON
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Gender:M
Credentials:DO
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Mailing Address - Street 1:26520 CACTUS AVE
Mailing Address - Street 2:GME OFFICE, RM A1005
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-3927
Mailing Address - Country:US
Mailing Address - Phone:951-486-5908
Mailing Address - Fax:951-486-5910
Practice Address - Street 1:26520 CACTUS AVE
Practice Address - Street 2:GME OFFICE, RM A1005
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-3927
Practice Address - Country:US
Practice Address - Phone:951-486-5908
Practice Address - Fax:951-486-5910
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2013-07-08
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Provider Licenses
StateLicense IDTaxonomies
CA20A11641207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology