Provider Demographics
NPI:1619567955
Name:DR. YOUNG HO CHA, D.D.S. CORP
Entity Type:Organization
Organization Name:DR. YOUNG HO CHA, D.D.S. CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:HO
Authorized Official - Last Name:CHA
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR
Authorized Official - Phone:909-725-3290
Mailing Address - Street 1:3818 PECK RD STE C
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-2260
Mailing Address - Country:US
Mailing Address - Phone:626-350-0944
Mailing Address - Fax:
Practice Address - Street 1:3818 PECK RD STE C
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-2260
Practice Address - Country:US
Practice Address - Phone:626-350-0944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty