MEDICARE: WONJIN CHOI

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	183500000X	Pharmacist	RPH 61879	CA

General Provider Information

NPI Number	:	1558681940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WONJIN CHOI

Provider Business Mailing Address
First Line	:	PO BOX 13371
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92255-3371
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	82422 MILES AVE
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92201-4250
Country	:	US
Telephone Number	:	760-347-3577
Fax Number	:

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

Provider Enumeration Date	:	06/08/2010
Last Update Date	:	03/07/2012

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Directions to “ WONJIN CHOI ” Practice Location

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