Healthcare Provider Details

I. General information

NPI: 1952938177
Provider Name (Legal Business Name): KATIE CHO CHINN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE A CHO

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 MARKET ST
SAN DIEGO CA
92102-4715
US

IV. Provider business mailing address

FILE 57326
LOS ANGELES CA
90074-0001
US

V. Phone/Fax

Practice location:
  • Phone: 619-515-2560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A21297
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA21297
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: