Healthcare Provider Details

I. General information

NPI: 1689683872
Provider Name (Legal Business Name): WON I CHOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 S BEACH BLVD
ANAHEIM CA
92804
US

IV. Provider business mailing address

919 S CAMERFORD LN
ANAHEIM CA
92808-2325
US

V. Phone/Fax

Practice location:
  • Phone: 714-821-1993
  • Fax:
Mailing address:
  • Phone: 714-514-2494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberA31280
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberA31280
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA31280
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: