Healthcare Provider Details

I. General information

NPI: 1992371884
Provider Name (Legal Business Name): JAE YOUNG CHOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26800 CROWN VALLEY PKWY STE 305
MISSION VIEJO CA
92691-8017
US

IV. Provider business mailing address

925 SENECA ST
SEATTLE WA
98101-2742
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-6000
  • Fax: 949-364-3213
Mailing address:
  • Phone: 206-583-6079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA207580
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: