Individual provider Active NPI

Man Chul Cho, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1902952559
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A42052 Issued in CA
Practice address
3130 W. Olympic Blvd., Suite 370
Los Angeles, CA 90006
Phone
(323) 733-1111
Fax
(323) 733-1113
NPI assigned
Jan 26, 2007
Last updated
May 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A42052 CA Primary

Addresses

Primary practice location

3130 W. Olympic Blvd., Suite 370
Los Angeles, CA 90006

Mailing address

3130 W Olympic Blvd Ste 370
Los Angeles, CA 90006-2657
Phone (323) 733-1111

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
I20090901000528 CA Practitioner - Psychiatry 5294880969 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3130 W Olympic Blvd
Suite 370
Los Angeles, CA 90006-2657
Phone (323) 733-1111

National Provider Directory

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1902952559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 W OLYMPIC BLVD STE 370",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062657",
            "telephone_number": "323-733-1111",
            "fax_number": "323-733-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 W. OLYMPIC BLVD., SUITE 370",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90006",
            "telephone_number": "323-733-1111",
            "fax_number": "323-733-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "MAN",
        "middle_name": "CHUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A42052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.