Provider Demographics
NPI:1710290895
Name:CHO, CHUN (LAC)
Entity Type:Individual
Prefix:
First Name:CHUN
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:11561 SHELLY VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-1141
Mailing Address - Country:US
Mailing Address - Phone:818-454-1510
Mailing Address - Fax:818-352-6351
Practice Address - Street 1:11561 SHELLY VISTA DR
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-1141
Practice Address - Country:US
Practice Address - Phone:818-454-1510
Practice Address - Fax:818-352-6351
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC12661171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist