Provider Demographics
NPI:1356490403
Name:CHO, NAMSOO DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:NAMSOO
Middle Name:DAVID
Last Name:CHO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2705
Mailing Address - Country:US
Mailing Address - Phone:215-885-9989
Mailing Address - Fax:215-885-7665
Practice Address - Street 1:435 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2705
Practice Address - Country:US
Practice Address - Phone:215-885-9989
Practice Address - Fax:215-885-7665
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008038L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA927627OtherBLUE CROSS
PA3358798OtherAETNA
PA2315838000OtherKEYSTONE HMO
PA047350Medicare ID - Type Unspecified