Healthcare Provider Details

I. General information

NPI: 1407176449
Provider Name (Legal Business Name): IN WOOK H. CHOI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2010
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W IMPERIAL HWY RITE AID
BREA CA
92821-4818
US

IV. Provider business mailing address

2342 CANYON PARK DR
DIAMOND BAR CA
91765-2801
US

V. Phone/Fax

Practice location:
  • Phone: 714-529-2176
  • Fax:
Mailing address:
  • Phone: 909-861-1650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH44262
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: