Healthcare Provider Details

I. General information

NPI: 1245273820
Provider Name (Legal Business Name): EDWIN H CHOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 11/23/2024
Certification Date: 11/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

866 S WESTMORELAND AVE STE 101
LOS ANGELES CA
90005-2372
US

IV. Provider business mailing address

866 S. WESTMORELAND AVENUE SUITE 101
LOS ANGELES CA
90005
US

V. Phone/Fax

Practice location:
  • Phone: 800-821-5675
  • Fax: 213-315-5195
Mailing address:
  • Phone: 800-821-5675
  • Fax: 213-289-1166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA54943
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: