Provider Demographics
NPI:1144322447
Name:CHA, YOUNG HO (DMD)
Entity type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:HO
Last Name:CHA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N AZUSA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1342
Mailing Address - Country:US
Mailing Address - Phone:626-915-8880
Mailing Address - Fax:626-915-8881
Practice Address - Street 1:151 N AZUSA AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1342
Practice Address - Country:US
Practice Address - Phone:626-915-8880
Practice Address - Fax:626-915-8881
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA492871223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics