MEDICARE: EURRI CHOI O.D

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	152W00000X	Optometrist	15108	CA

General Provider Information

NPI Number	:	1518367325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EURRI CHOI O.D

Provider Business Mailing Address
First Line	:	6134 PACIFIC BLVD
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-2923
Country	:	US
Telephone Number	:	323-589-3381
Fax Number	:	323-583-6439

Provider Business Practice Location Address
First Line	:	6134 PACIFIC BLVD
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-2923
Country	:	US
Telephone Number	:	323-589-3381
Fax Number	:	323-583-6439

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

Provider Enumeration Date	:	08/28/2014
Last Update Date	:	08/28/2014

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