Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1114157732 |
---|---|
Provider Name | Young Cho |
First Address | Santa Clara, CA 95051-3061 |
Second Address | Santa Clara, CA 95051-3061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2009 |
Last Update Date | 26/03/2011 |