Jong Cho
Individual provider Active NPI Pharmacist · La, CA
NPI 1134675853 · NPPES record last updated Sep 1, 2016
Key facts
- NPI
- 1134675853
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 45379 (CA)
- Practice address
- 1645 E. 103Rd St
La, CA 90002 - Phone
- (323) 564-7127
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45379 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 45379 | CA | Yes |
Addresses
Primary practice location
1645 E. 103Rd St
La, CA 90002
Mailing address
1645 E. 103Rd St
La, CA 90002
Other providers in La, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.