Healthcare Provider Details

I. General information

NPI: 1326351735
Provider Name (Legal Business Name): RACHEL TAI YOUNG CHO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 6TH AVE
DES MOINES IA
50314-2611
US

IV. Provider business mailing address

1111 6TH AVE
DES MOINES IA
50314-2611
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-2261
  • Fax:
Mailing address:
  • Phone: 515-643-2261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR-8918
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4452
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: