Provider Demographics
NPI:1598974032
Name:CHO, LELAND (DDS)
Entity Type:Individual
Prefix:DR
First Name:LELAND
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:11300 17TH. AVE.
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-0550
Mailing Address - Country:US
Mailing Address - Phone:559-381-0938
Mailing Address - Fax:559-924-9351
Practice Address - Street 1:11300 17TH AVE
Practice Address - Street 2:11300 17TH AVE
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-9117
Practice Address - Country:US
Practice Address - Phone:559-381-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice