Provider Demographics
NPI:1477696474
Name:JOHN S. CHO, M.D., INC.
Entity Type:Organization
Organization Name:JOHN S. CHO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-989-3155
Mailing Address - Street 1:9674 ARCHIBALD AVE STE 175
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7967
Mailing Address - Country:US
Mailing Address - Phone:909-989-3155
Mailing Address - Fax:909-989-3195
Practice Address - Street 1:9674 ARCHIBALD AVE STE 175
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7967
Practice Address - Country:US
Practice Address - Phone:909-989-3155
Practice Address - Fax:909-989-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67584207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ27517ZOtherMEDICARE