Provider Demographics
NPI:1649577156
Name:CHO, HANWON H (MD)
Entity Type:Individual
Prefix:
First Name:HANWON
Middle Name:H
Last Name:CHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11706 MONTANA AVE APT 210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6724
Mailing Address - Country:US
Mailing Address - Phone:310-826-3740
Mailing Address - Fax:
Practice Address - Street 1:11706 MONTANA AVE APT 210
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-6724
Practice Address - Country:US
Practice Address - Phone:310-826-3740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACFE39605207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACFE39605OtherPHYSICIAN & SURGEON
CA3016151536OtherAARP