Healthcare Provider Details

I. General information

NPI: 1144612060
Provider Name (Legal Business Name): SANG H CHOI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N VERMONT AVE DOCTORS TOWER # 100
LOS ANGELES CA
90027-6005
US

IV. Provider business mailing address

1300 N VERMONT AVE DOCTORS TOWER # 100
LOS ANGELES CA
90027-6005
US

V. Phone/Fax

Practice location:
  • Phone: 323-913-4350
  • Fax: 323-913-4351
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SANG H CHOI
Title or Position: OWNER
Credential:
Phone: 323-913-4350