Provider Demographics
NPI:1164820064
Name:EOM-CHO, SOYOUNG (PHARM D)
Entity type:Individual
Prefix:
First Name:SOYOUNG
Middle Name:
Last Name:EOM-CHO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 DAZZLING GOLD ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-1564
Mailing Address - Country:US
Mailing Address - Phone:702-499-1889
Mailing Address - Fax:
Practice Address - Street 1:9705 PYRAMID WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89441-7541
Practice Address - Country:US
Practice Address - Phone:775-425-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist