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General NPI Number Information
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NPI Number | 1720311632
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Entity Type | Individual
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Provider Name | SIMON CHO O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 17150 GALE AVE
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91745-1809
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Country | US
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Telephone | 626-854-1166
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Fax |
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Provider Business Mailing Address
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Address Line | 731 FAIRVIEW AVE APT 7
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City | ARCADIA
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State | CA
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Zip | 91007-6697
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Country | US
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Telephone |
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Fax |
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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 | 13790
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License Number State | CA
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