Healthcare Provider Details

I. General information

NPI: 1356078307
Provider Name (Legal Business Name): SOOHYUN CHOE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 ADAMS AVE
COSTA MESA CA
92626-4958
US

IV. Provider business mailing address

20151 SW BIRCH ST
NEWPORT BEACH CA
92660-1793
US

V. Phone/Fax

Practice location:
  • Phone: 949-270-2100
  • Fax: 949-650-4458
Mailing address:
  • Phone: 949-270-2100
  • Fax: 949-650-4458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95021096
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: