Provider Demographics
NPI:1811348329
Name:CHO, DONGSAM I (AC 16276)
Entity type:Individual
Prefix:DR
First Name:DONGSAM
Middle Name:
Last Name:CHO
Suffix:I
Gender:M
Credentials:AC 16276
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8736 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1251
Mailing Address - Country:US
Mailing Address - Phone:714-591-5611
Mailing Address - Fax:
Practice Address - Street 1:8736 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844
Practice Address - Country:US
Practice Address - Phone:714-591-5611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist