MEDICARE: DR. PAHNSONG CHO DDS

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	122300000X	Dentist	50738	CA

General Provider Information

NPI Number	:	1316294515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAHNSONG CHO DDS

Provider Business Mailing Address
First Line	:	2729 PEPPERDALE DR
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-4933
Country	:	US
Telephone Number	:	213-210-4188
Fax Number	:

Provider Business Practice Location Address
First Line	:	2729 PEPPERDALE DR
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-4933
Country	:	US
Telephone Number	:	213-210-4188
Fax Number	:

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

Provider Enumeration Date	:	08/07/2012
Last Update Date	:	03/10/2022

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