Basic Information
Provider Information
NPI: 1922211390
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHO
FirstName: LESLIE
MiddleName: D
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 245
Address2:  
City: KAHULUI
State: HI
PostalCode: 967336745
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 221 MAHALANI ST
Address2:  
City: WAILUKU
State: HI
PostalCode: 967932526
CountryCode: US
TelephoneNumber: 8082422290
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/08/2007
LastUpdateDate: 04/01/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X98248CAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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