Provider Demographics
NPI:1881305159
Name:CHO, RAY SUNG JIN (RPH)
Entity type:Individual
Prefix:MR
First Name:RAY
Middle Name:SUNG JIN
Last Name:CHO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 CAMROSE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-2102
Mailing Address - Country:US
Mailing Address - Phone:408-817-0491
Mailing Address - Fax:
Practice Address - Street 1:855 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2305
Practice Address - Country:US
Practice Address - Phone:650-322-2707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87243183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist