Healthcare Provider Details

I. General information

NPI: 1578667564
Provider Name (Legal Business Name): YUNG R CHO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6758 PASSONS BLVD
PICO RIVERA CA
90660
US

IV. Provider business mailing address

6758 PASSONS BLVD
PICO RIVERA CA
90660
US

V. Phone/Fax

Practice location:
  • Phone: 562-654-6899
  • Fax: 562-654-6895
Mailing address:
  • Phone: 562-654-6899
  • Fax: 562-654-6895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA46321
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierGR0066390 GR0066391
Identifier TypeMEDICAID
Identifier StateCA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: