=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528277639
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SORAE CHO AC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10160 MASON AVE
-----------------------------------------------------
City | CHATSWORTH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91311-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-998-6845
-----------------------------------------------------
Fax | 818-998-6840
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10160 MASON AVE
-----------------------------------------------------
City | CHATSWORTH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91311-3301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-998-6845
-----------------------------------------------------
Fax | 818-998-6840
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC7387
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------