=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972821759
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HYUN SOO CHO PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2010
-----------------------------------------------------
Last Update Date | 05/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18993 COLIMA RD
-----------------------------------------------------
City | ROWLAND HEIGHTS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91748
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-964-6714
-----------------------------------------------------
Fax | 626-964-0814
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15150 CALLE BARCELONA
-----------------------------------------------------
City | CHINO HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-606-6984
-----------------------------------------------------
Fax | 626-964-0814
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 53199
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------