Provider Demographics
NPI:1619271038
Name:CHO, YOOMI (PA)
Entity Type:Individual
Prefix:
First Name:YOOMI
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 AVOCADO AVE STE 703
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-8710
Mailing Address - Country:US
Mailing Address - Phone:949-760-0190
Mailing Address - Fax:949-760-0439
Practice Address - Street 1:1401 AVOCADO AVE STE 703
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-8710
Practice Address - Country:US
Practice Address - Phone:949-760-0190
Practice Address - Fax:949-760-0439
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21070363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant