Provider Demographics
NPI:1184770323
Name:CHO, KYU YOON (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:
First Name:KYU YOON
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 N CENTRAL AVE APT 1309
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-3678
Mailing Address - Country:US
Mailing Address - Phone:818-549-1593
Mailing Address - Fax:
Practice Address - Street 1:2405 W 8TH ST STE 103
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-5016
Practice Address - Country:US
Practice Address - Phone:213-384-8909
Practice Address - Fax:213-384-4942
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH48207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARPH48207OtherREGISTERED PHARMACIST