MEDICARE: DR. AHRA 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
1	207R00000X	Internal Medicine Physician	A117269	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W18762	OTHER	CA	GROUP MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	GR0100430	OTHER	CA	GROUP MEDICAL
3	1902846306	OTHER	CA	GROUP NPI

General Provider Information

NPI Number	:	1902051659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHRA CHO M.D.

Provider Business Mailing Address
First Line	:	2727 W OLYMPIC BLVD STE 205
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2640
Country	:	US
Telephone Number	:	213-529-4251
Fax Number	:	213-529-4250

Provider Business Practice Location Address
First Line	:	2727 W OLYMPIC BLVD STE 205
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2640
Country	:	US
Telephone Number	:	213-529-4251
Fax Number	:

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

Provider Enumeration Date	:	11/22/2008
Last Update Date	:	10/11/2023

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