Provider Demographics
NPI:1205501913
Name:RHEE, CHARLES CHULJOO (MS T, M ED)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:CHULJOO
Last Name:RHEE
Suffix:
Gender:M
Credentials:MS T, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 FRANCES CIR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-5000
Mailing Address - Country:US
Mailing Address - Phone:213-700-5613
Mailing Address - Fax:
Practice Address - Street 1:333 CITY BLVD W FL 17
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-5905
Practice Address - Country:US
Practice Address - Phone:213-700-5613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician