Provider Demographics
NPI:1386858512
Name:CHO, JEONG SOOK
Entity Type:Individual
Prefix:
First Name:JEONG SOOK
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18734 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2916
Mailing Address - Country:US
Mailing Address - Phone:626-810-1420
Mailing Address - Fax:626-810-1494
Practice Address - Street 1:18734 COLIMA RD
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2916
Practice Address - Country:US
Practice Address - Phone:626-810-1420
Practice Address - Fax:626-810-1494
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11644171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist