Healthcare Provider Details

I. General information

NPI: 1104752526
Provider Name (Legal Business Name): YONG NAM CHO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2819 DUKE ST
ALEXANDRIA VA
22314-4512
US

IV. Provider business mailing address

2819 DUKE ST
ALEXANDRIA VA
22314-4512
US

V. Phone/Fax

Practice location:
  • Phone: 703-370-2830
  • Fax:
Mailing address:
  • Phone: 703-370-2830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121001276
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: