Provider Demographics
NPI:1508038084
Name:CHO, OEN HA (FNP)
Entity Type:Individual
Prefix:
First Name:OEN
Middle Name:HA
Last Name:CHO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:OENHA
Other - Middle Name:
Other - Last Name:PAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:10440 BLACK MOUNTAIN RD, K-2 BUILDING
Mailing Address - Street 2:SAN DIEGO MIRAMAR COLLEGE STUDENT HEALTH CENTER
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126
Mailing Address - Country:US
Mailing Address - Phone:619-388-7881
Mailing Address - Fax:
Practice Address - Street 1:10440 BLACK MOUNTAIN RD, K-2 BUILDING
Practice Address - Street 2:SAN DIEGO MIRAMAR COLLEGE STUDENT HEALTH CENTER
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126
Practice Address - Country:US
Practice Address - Phone:619-388-7881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA614946163W00000X
CA17533363L00000X
CAF1107161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner