1679695399 NPI number — CHIN-SUK JOHN CHO D.C, DACBR, RMSK

Table of content: CHIN-SUK JOHN CHO D.C, DACBR, RMSK (NPI 1679695399)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679695399 NPI number — CHIN-SUK JOHN CHO D.C, DACBR, RMSK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHO
Provider First Name:
CHIN-SUK
Provider Middle Name:
JOHN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C, DACBR, RMSK
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679695399
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2550 STATE HWY 121
Provider Second Line Business Mailing Address:
BUILDING 2
Provider Business Mailing Address City Name:
LEWISVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
525 W CHESTER PIKE
Provider Second Line Business Practice Location Address:
SUITE #103A
Provider Business Practice Location Address City Name:
HAVERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19083-4500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-789-3678
Provider Business Practice Location Address Fax Number:
610-789-3679
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111NR0200X , with the licence number:  13616 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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