Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 75694 | AZ |
N | 111NI0900X | Internist | 75694 | AZ |
Y | 207RN0300X | Nephrologist | 13530 | NV |
NPI | 1053512566 |
---|---|
Provider Name | Dr. Charles Cho |
First Address | Los Angeles, CA 90020-1406 |
Second Address | Los Angeles, CA 90020-1406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 13/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053512566 | (05) | NV |