Provider Demographics
NPI:1891915187
Name:CHO, CHE BONG (ACUPUNCTURIST, OMD)
Entity Type:Individual
Prefix:DR
First Name:CHE BONG
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:ACUPUNCTURIST, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4024 WILLIAMSBURG CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-1139
Mailing Address - Country:US
Mailing Address - Phone:703-278-0607
Mailing Address - Fax:703-278-0608
Practice Address - Street 1:4024 WILLIAMSBURG CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-1139
Practice Address - Country:US
Practice Address - Phone:703-278-0607
Practice Address - Fax:703-278-0608
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000415171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist