Healthcare Provider Details

I. General information

NPI: 1942591847
Provider Name (Legal Business Name): JONAH MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2011
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: 213-380-2266
  • Fax: 213-315-5195
Mailing address:
  • Phone: 800-821-5675
  • Fax: 213-289-1166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWIN CHOI
Title or Position: OWNER/CEO
Credential: M.D.
Phone: 800-821-5675