Provider Demographics
NPI:1164048856
Name:CHO, ELIZABETH JAYUN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JAYUN
Last Name:CHO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16615 SURREY PL
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-3777
Mailing Address - Country:US
Mailing Address - Phone:626-315-0331
Mailing Address - Fax:
Practice Address - Street 1:2130 SAWTELLE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6266
Practice Address - Country:US
Practice Address - Phone:424-248-3670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty