Provider Demographics
NPI:1518234012
Name:CHO, CRISTINA EUNSUN (PHAMD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:EUNSUN
Last Name:CHO
Suffix:
Gender:F
Credentials:PHAMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 E IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-2318
Mailing Address - Country:US
Mailing Address - Phone:310-609-2406
Mailing Address - Fax:310-609-2471
Practice Address - Street 1:4351 E IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2318
Practice Address - Country:US
Practice Address - Phone:310-609-2406
Practice Address - Fax:310-609-2471
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist