Provider Demographics
NPI:1831924992
Name:CHO, THOMAS MATTHEW TAEHI
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:MATTHEW TAEHI
Last Name:CHO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 W UNION AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1239
Mailing Address - Country:US
Mailing Address - Phone:562-631-1971
Mailing Address - Fax:
Practice Address - Street 1:2585 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3605
Practice Address - Country:US
Practice Address - Phone:714-879-3901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health