MEDICARE: DR. LUKE KYUNG-GOO CHOI D.D.S., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	34316	CA

General Provider Information

NPI Number	:	1003905829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUKE KYUNG-GOO CHOI D.D.S., M.S.

Provider Business Mailing Address
First Line	:	1001 E CHAPMAN AVE
Second Line	:	SUITE A
City	:	FULLERTON
State	:	CA
Zip	:	92831-3811
Country	:	US
Telephone Number	:	714-871-7000
Fax Number	:	714-871-7080

Provider Business Practice Location Address
First Line	:	1001 E CHAPMAN AVE
Second Line	:	SUITE A
City	:	FULLERTON
State	:	CA
Zip	:	92831-3811
Country	:	US
Telephone Number	:	714-871-7000
Fax Number	:	714-871-7080

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2007

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