Provider Demographics
NPI:1760584551
Name:CHO, HAE-YOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:HAE-YOUNG
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11160 WARNER AVE
Mailing Address - Street 2:STE 213
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4008
Mailing Address - Country:US
Mailing Address - Phone:714-241-7732
Mailing Address - Fax:714-241-9517
Practice Address - Street 1:11160 WARNER AVE
Practice Address - Street 2:STE 213
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4008
Practice Address - Country:US
Practice Address - Phone:714-241-7732
Practice Address - Fax:714-241-9517
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36576174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist