Provider Demographics
NPI:1649754342
Name:CHO, YONG IL (DDS)
Entity Type:Individual
Prefix:DR
First Name:YONG IL
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:CHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:11819 CENTRAL AVE APT 608
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-6492
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11819 CENTRAL AVE APT 608
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-6492
Practice Address - Country:US
Practice Address - Phone:415-298-2551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1029951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice