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General NPI Number Information
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NPI Number | 1386853158
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Entity Type | Individual
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Provider Name | HYONG J CHO OD
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 13059 FAIRLAKE SHOPPING CENTER
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City | FAIRFAX
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State | VA
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Zip | 22033
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Country | US
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Telephone | 703-631-5131
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Fax |
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Provider Business Mailing Address
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Address Line | 25574 DAPPER CT
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City | CHANTILLY
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State | VA
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Zip | 20152-6318
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Country | US
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Telephone | 571-215-1346
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Fax | 703-631-5132
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618001212
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License Number State | VA
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