Healthcare Provider Details

I. General information

NPI: 1952022816
Provider Name (Legal Business Name): MATTHEW CHO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 ROSCOE BLVD
NORTHRIDGE CA
91325-4105
US

IV. Provider business mailing address

18300 ROSCOE BLVD
NORTHRIDGE CA
91325-4105
US

V. Phone/Fax

Practice location:
  • Phone: 855-396-0017
  • Fax:
Mailing address:
  • Phone: 855-396-0017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number24851
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: