Provider Demographics
NPI:1942822887
Name:CHO, JONATHAN JOSEPH (MD PHD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:JOSEPH
Last Name:CHO
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 100111 BOX 1
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96629-1100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USS CARL VINSON (CVN-70)
Practice Address - Street 2:UNIT 100111
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96629
Practice Address - Country:US
Practice Address - Phone:619-545-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
VA0101273004207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider