Provider Demographics
NPI:1770815805
Name:CHO, PAUL SUNGMIN (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SUNGMIN
Last Name:CHO
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 REDONDA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1954
Mailing Address - Country:US
Mailing Address - Phone:949-677-3565
Mailing Address - Fax:
Practice Address - Street 1:12 REDONDA
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-1954
Practice Address - Country:US
Practice Address - Phone:949-677-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30952111N00000X
CAAC11943171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor