Individual provider Active NPI

Peter Young Cho, MD

  • Family Medicine Physician
  • Stockton, CA
National Provider Identifier
1619968948
Registry record updated Oct 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G80908 Issued in CA
Practice address
75 W March LN Ste H
Stockton, CA 95207-5729
Phone
(909) 254-3793
NPI assigned
Nov 4, 2005
Last updated
Oct 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G80908 CA Primary

Addresses

Primary practice location

75 W March LN Ste H
Stockton, CA 95207-5729

Mailing address

4719 Quail Lakes Dr
G #1019
Stockton, CA 95207
Phone (209) 565-3612

Other identifiers 1

IdentifierTypeStateIssuer
00G809081MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413001007 CA Practitioner - Family Practice 2961468830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G80908CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Valley Health Center CurrentSince Sep 2, 2021 Accepting new patients
Ukiah Adventist Hospital Past Accepting new patients

Locations

50 Branscomb Rd
Laytonville, CA 95454
Phone (707) 984-6131

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AECBBA

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791590400000",
    "number": "1619968948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 QUAIL LAKES DR",
            "address_2": "G #1019",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95207",
            "telephone_number": "209-565-3612",
            "fax_number": "707-282-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 W MARCH LN STE H",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075729",
            "telephone_number": "909-254-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "PETER",
        "middle_name": "YOUNG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-10-10",
        "certification_date": "2026-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G80908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G809081",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.