Healthcare Provider Details

I. General information

NPI: 1801713326
Provider Name (Legal Business Name): JUN HYEOK CHOI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 E PHILADELPHIA ST STE 150
ONTARIO CA
91761-2963
US

IV. Provider business mailing address

1265 HARBOR LAKE AVE
BREA CA
92821-2860
US

V. Phone/Fax

Practice location:
  • Phone: 909-773-0022
  • Fax: 909-781-6015
Mailing address:
  • Phone: 562-965-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: