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NPI Code Detail

MEDICARE: DR. JAE SUNG CHO M.D.

MEDICARE: DR. JAE SUNG CHO M.D.
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
12086S0129XVascular Surgery PhysicianG86408CA

General Provider Information

NPI Number : 1578535001
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAE SUNG CHO M.D.
Provider Business Mailing Address
First Line : 236 SAN JOSE ST
Second Line :
City : SALINAS
State : CA
Zip : 93901-3901
Country : US
Telephone Number : 831-424-7389
Fax Number : 831-424-3027
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE STE 1800
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-844-3013
Fax Number : 216-844-7716
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 12/30/2020

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