Healthcare Provider Details

I. General information

NPI: 1093486060
Provider Name (Legal Business Name): CHRISTINA CHO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 PEACHTREE RD NE STE 650
ATLANTA GA
30309-1432
US

IV. Provider business mailing address

3732 MEADOW RUE LN
PEACHTREE CORNERS GA
30092-2228
US

V. Phone/Fax

Practice location:
  • Phone: 404-253-3655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11578
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number11578
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: