Healthcare Provider Details

I. General information

NPI: 1801594478
Provider Name (Legal Business Name): STEPHANIE CHO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23622 CALABASAS RD STE 101
CALABASAS CA
91302-1584
US

IV. Provider business mailing address

23622 CALABASAS RD STE 101
CALABASAS CA
91302-1584
US

V. Phone/Fax

Practice location:
  • Phone: 818-222-4543
  • Fax:
Mailing address:
  • Phone: 818-222-4543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number112807
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: