Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 51053 | CA |
NPI | 1083792956 |
---|---|
Provider Name | Dr. William J Cho |
First Address | Carlsbad, CA 92008-6858 |
Second Address | Carlsbad, CA 92008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 03/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1083792956 | PERIODONTIST (01) | CA |