Healthcare Provider Details

I. General information

NPI: 1306512496
Provider Name (Legal Business Name): EUNICE CHOI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 S INDIAN HILL BLVD STE 5
CLAREMONT CA
91711-5461
US

IV. Provider business mailing address

26197 CITRON ST
LOMA LINDA CA
92354-6575
US

V. Phone/Fax

Practice location:
  • Phone: 909-451-8521
  • Fax:
Mailing address:
  • Phone: 404-274-9538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number22677
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: