Provider Demographics
NPI:1881906741
Name:CHO, SUNG S (LAC ACUPUNCTURE)
Entity type:Individual
Prefix:
First Name:SUNG
Middle Name:S
Last Name:CHO
Suffix:
Gender:F
Credentials:LAC ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 MARICOPA ST
Mailing Address - Street 2:#1405
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:818-788-9699
Mailing Address - Fax:818-720-7887
Practice Address - Street 1:15611 VENTURA BL
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-788-9699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5469171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist