Healthcare Provider Details

I. General information

NPI: 1225072481
Provider Name (Legal Business Name): ANDREW S CHO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 W 3RD ST SUITE 206
LOS ANGELES CA
90020-3450
US

IV. Provider business mailing address

4220 W 3RD ST SUITE 206
LOS ANGELES CA
90020-3450
US

V. Phone/Fax

Practice location:
  • Phone: 213-380-8800
  • Fax: 213-381-7474
Mailing address:
  • Phone: 213-380-8800
  • Fax: 213-381-7474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA61194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: