Provider Demographics
NPI:1871332601
Name:CHO, SO HYUN (FNP)
Entity type:Individual
Prefix:
First Name:SO HYUN
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 METRO CT
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-2481
Mailing Address - Country:US
Mailing Address - Phone:213-200-3268
Mailing Address - Fax:
Practice Address - Street 1:6301 BEACH BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-4030
Practice Address - Country:US
Practice Address - Phone:714-994-5290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030189363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily