Provider Demographics
NPI:1528308061
Name:CHO, EUN A (PA)
Entity type:Individual
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First Name:EUN
Middle Name:A
Last Name:CHO
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Gender:F
Credentials:PA
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Mailing Address - Street 1:12828 HARBOR BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-5834
Mailing Address - Country:US
Mailing Address - Phone:714-636-3032
Mailing Address - Fax:714-636-3116
Practice Address - Street 1:8700 WARNER AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3207
Practice Address - Country:US
Practice Address - Phone:714-847-6727
Practice Address - Fax:714-770-8236
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2015-09-14
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Provider Licenses
StateLicense IDTaxonomies
CAPA22774363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA22774OtherCA PHYSICIAN ASSISTANT LICENSE