Healthcare Provider Details

I. General information

NPI: 1699458877
Provider Name (Legal Business Name): ROBIN DIANE CHO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN DIANE MULVANEY NP

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
LOS ANGELES CA
90048-1804
US

IV. Provider business mailing address

2022 DELAWARE AVE APT 7
SANTA MONICA CA
90404-4865
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-5427
  • Fax:
Mailing address:
  • Phone: 317-440-5973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberNP95024027
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: