Provider Demographics
NPI:1164628913
Name:CHO, KATHERINE HYUNSOOK (LAC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:HYUNSOOK
Last Name:CHO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3460 WILSHIRE BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2223
Mailing Address - Country:US
Mailing Address - Phone:213-413-9500
Mailing Address - Fax:213-413-5400
Practice Address - Street 1:3460 WILSHIRE BLVD STE 500
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2223
Practice Address - Country:US
Practice Address - Phone:213-413-9500
Practice Address - Fax:213-413-5400
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4924171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist