Provider Demographics
NPI:1295210839
Name:CHO, NAMWOOK (LAC)
Entity Type:Individual
Prefix:
First Name:NAMWOOK
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18021 NORWALK BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-4254
Mailing Address - Country:US
Mailing Address - Phone:213-700-4950
Mailing Address - Fax:
Practice Address - Street 1:18021 NORWALK BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-4254
Practice Address - Country:US
Practice Address - Phone:213-700-4950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-29
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15790171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist