Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 49287 | CA |
NPI | 1144322447 |
---|---|
Provider Name | Dr. Young Ho Cha |
First Address | West Covina, CA 91791-1342 |
Second Address | West Covina, CA 91791-1342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 17/12/2020 |