Provider Demographics
NPI:1841571320
Name:CHO, HYUNAH
Entity Type:Individual
Prefix:DR
First Name:HYUNAH
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11152 DALLAS PL
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-6553
Mailing Address - Country:US
Mailing Address - Phone:909-894-9304
Mailing Address - Fax:
Practice Address - Street 1:11152 DALLAS PL
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-6553
Practice Address - Country:US
Practice Address - Phone:909-894-9304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60650122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist