Healthcare Provider Details

I. General information

NPI: 1295871747
Provider Name (Legal Business Name): JAMES YOUNG CHOI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 W THUNDERBIRD RD C300
GLENDALE AZ
85306-4660
US

IV. Provider business mailing address

5750 W THUNDERBIRD RD C300
GLENDALE AZ
85306-4660
US

V. Phone/Fax

Practice location:
  • Phone: 602-938-2848
  • Fax: 602-938-4606
Mailing address:
  • Phone: 602-938-2848
  • Fax: 602-938-4606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number32010
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: