Provider Demographics
NPI:1023657350
Name:CHO, YOUNG LAN
Entity type:Individual
Prefix:
First Name:YOUNG LAN
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 E OAKEY BLVD # 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-1403
Mailing Address - Country:US
Mailing Address - Phone:702-686-3372
Mailing Address - Fax:
Practice Address - Street 1:5292 S MARYLAND PKWY APT 159
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-1974
Practice Address - Country:US
Practice Address - Phone:702-333-0130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide