MEDICARE: ELLEN CHO PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	71671	CA

General Provider Information

NPI Number	:	1083076095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN CHO PHARMD

Provider Business Mailing Address
First Line	:	12746 W JEFFERSON BLVD
Second Line	:	SUITE 3160
City	:	LOS ANGELES
State	:	CA
Zip	:	90094-2885
Country	:	US
Telephone Number	:	310-862-9810
Fax Number	:	310-862-9811

Provider Business Practice Location Address
First Line	:	12746 W JEFFERSON BLVD
Second Line	:	SUITE 3160
City	:	LOS ANGELES
State	:	CA
Zip	:	90094-2885
Country	:	US
Telephone Number	:	310-862-9810
Fax Number	:	310-862-9811

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2016
Last Update Date	:	03/28/2016

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