Provider Demographics
NPI:1699292656
Name:CHO, MICHELLE DUONG (OD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:DUONG
Last Name:CHO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:2581 ARVIA ST UNIT 28
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-3177
Mailing Address - Country:US
Mailing Address - Phone:657-223-3140
Mailing Address - Fax:
Practice Address - Street 1:141 N GLASSELL ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1406
Practice Address - Country:US
Practice Address - Phone:657-223-3140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33801TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist