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NPI Code Detail

MEDICARE: SUSAN CHO NP

MEDICARE: SUSAN CHO NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerNP95006724CA

General Provider Information

NPI Number : 1104379692
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN CHO NP
Provider Business Mailing Address
First Line : 3861 SEPULVEDA BLVD
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4605
Country : US
Telephone Number : 310-450-2191
Fax Number : 310-450-0873
Provider Business Practice Location Address
First Line : 3861 SEPULVEDA BLVD
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4605
Country : US
Telephone Number : 310-450-2191
Fax Number : 310-450-0873
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2016
Last Update Date : 06/01/2026

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