Provider Demographics
NPI:1104061357
Name:CHO, JOONG HYUN (LAC)
Entity type:Individual
Prefix:
First Name:JOONG HYUN
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:958 WANDA AVE APT B
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955-5330
Mailing Address - Country:US
Mailing Address - Phone:714-595-0377
Mailing Address - Fax:
Practice Address - Street 1:1001 PACIFIC ST STE D
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4455
Practice Address - Country:US
Practice Address - Phone:831-375-0377
Practice Address - Fax:831-375-0377
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12648171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist