Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner |
NPI | 1023389236 |
---|---|
Provider Name | Ms. Su Hyun Cho |
First Address | Costa Mesa, CA 92626-4652 |
Second Address | Costa Mesa, CA 92626-4652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2012 |
Last Update Date | 22/09/2015 |