Provider Demographics
NPI:1699458877
Name:CHO, ROBIN DIANE (NP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:DIANE
Last Name:CHO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:DIANE
Other - Last Name:MULVANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2022 DELAWARE AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-4865
Mailing Address - Country:US
Mailing Address - Phone:317-440-5973
Mailing Address - Fax:
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-423-5427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95024027363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine