Provider Demographics
NPI:1184264111
Name:CHO, KUG NAM (L AC)
Entity type:Individual
Prefix:MR
First Name:KUG NAM
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:444 LUCAS AVE APT 73
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2069
Mailing Address - Country:US
Mailing Address - Phone:213-275-8764
Mailing Address - Fax:
Practice Address - Street 1:28924 S WESTERN AVE STE 207
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-0814
Practice Address - Country:US
Practice Address - Phone:213-275-8764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist