Provider Demographics
NPI:1134548076
Name:CHO, KI HAENG (LAC)
Entity type:Individual
Prefix:DR
First Name:KI HAENG
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:758 E COLORADO BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2128
Mailing Address - Country:US
Mailing Address - Phone:626-356-7561
Mailing Address - Fax:626-628-1894
Practice Address - Street 1:758 E COLORADO BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2128
Practice Address - Country:US
Practice Address - Phone:626-356-7561
Practice Address - Fax:626-628-1894
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14515171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist