Healthcare Provider Details

I. General information

NPI: 1972081412
Provider Name (Legal Business Name): AHRA CHO M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 04/02/2024
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 W OLYMPIC BLVD STE 205
LOS ANGELES CA
90006-2640
US

IV. Provider business mailing address

2727 W OLYMPIC BLVD STE 205
LOS ANGELES CA
90006-2640
US

V. Phone/Fax

Practice location:
  • Phone: 213-529-4251
  • Fax: 213-529-4250
Mailing address:
  • Phone: 213-529-4251
  • Fax: 213-529-4250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. AHRA CHO
Title or Position: PRESIDENT
Credential: MD
Phone: 213-529-4251