MEDICARE: KATHERINE HYUNSOOK CHO LAC

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	171100000X	Acupuncturist	AC4924	CA

General Provider Information

NPI Number	:	1164628913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE HYUNSOOK CHO LAC

Provider Business Mailing Address
First Line	:	3460 WILSHIRE BLVD STE 500
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2223
Country	:	US
Telephone Number	:	213-413-9500
Fax Number	:	213-413-5400

Provider Business Practice Location Address
First Line	:	3460 WILSHIRE BLVD STE 500
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2223
Country	:	US
Telephone Number	:	213-413-9500
Fax Number	:	213-413-5400

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

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	05/06/2015

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