Provider Demographics
NPI:1497963961
Name:CHO, TED MYUNG (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MR
First Name:TED
Middle Name:MYUNG
Last Name:CHO
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:MR
Other - First Name:TAE
Other - Middle Name:MYUNG
Other - Last Name:CHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACUPUNCTURIST
Mailing Address - Street 1:4831 WINDSONG AVE
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1952
Mailing Address - Country:US
Mailing Address - Phone:714-761-7258
Mailing Address - Fax:
Practice Address - Street 1:4831 WINDSONG AVE
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1952
Practice Address - Country:US
Practice Address - Phone:714-761-7258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4863171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist