Basic Information
Provider Information
NPI: 1104582428
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHO
FirstName: SARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MS, OTR/L, CNS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11301 WILSHIRE BLVD
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900731003
CountryCode: US
TelephoneNumber: 3104783711
FaxNumber:  
Practice Location
Address1: 11301 WILSHIRE BLVD
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900731003
CountryCode: US
TelephoneNumber: 3104783711
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/10/2021
LastUpdateDate: 01/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X18341CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home