Basic Information
Provider Information
NPI: 1922537539
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHO
FirstName: ERIC
MiddleName: Y
NamePrefix:  
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Credential:  
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Mailing Information
Address1: PO BOX 232410
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921932410
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 200 W ARBOR DR
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921039000
CountryCode: US
TelephoneNumber: 8009268273
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/07/2017
LastUpdateDate: 07/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 07/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208800000XA175739CAY Allopathic & Osteopathic PhysiciansUrology 
208600000XMT213129PAN Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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