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General NPI Number Information
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NPI Number | 1720536923
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Entity Type | Organization
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Legal Business Name | JKC NEUROLOGY MEDICAL GROUP INC
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Dates
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Enumeration Date | 09/15/2016
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Last Update Date | 09/29/2016
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Provider Practice Location Address
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Address Line | 3550 WILSHIRE BLVD STE 650
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City | LOS ANGELES
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State | CA
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Zip | 90010-2440
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Country | US
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Telephone | 213-487-3060
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Fax | 213-388-7168
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Provider Business Mailing Address
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Address Line | 3550 WILSHIRE BLVD STE 650
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City | LOS ANGELES
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State | CA
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Zip | 90010-2440
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Country | US
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Telephone | 213-487-3060
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Fax | 213-388-7168
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KYUNG KU CHO
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Credential | M.D
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Telephone | 213-487-3060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A44986
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License Number State | CA
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