Healthcare Provider Details

I. General information

NPI: 1699973214
Provider Name (Legal Business Name): SUSANNA N CHOI-LIN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

18946 VICKIE AVE APT 246
CERRITOS CA
90703-6203
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-5757
  • Fax:
Mailing address:
  • Phone: 562-860-2763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NR10012500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: