Healthcare Provider Details

I. General information

NPI: 1154856649
Provider Name (Legal Business Name): JOANNE JEEYOUNG CHO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2017
Last Update Date: 06/22/2020
Certification Date: 06/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 LOMITA BLVD SUITE 200
HARBOR CITY CA
90710-2076
US

IV. Provider business mailing address

1403 LOMITA BLVD SUITE 200
HARBOR CITY CA
90710-2076
US

V. Phone/Fax

Practice location:
  • Phone: 310-534-7600
  • Fax:
Mailing address:
  • Phone: 310-534-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA157609
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: