Healthcare Provider Details

I. General information

NPI: 1346554615
Provider Name (Legal Business Name): KYUJIN CHOI PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S BLDG 25A
ORANGE CA
92868-3201
US

IV. Provider business mailing address

24004 68TH AVE
DOUGLASTON NY
11362-1929
US

V. Phone/Fax

Practice location:
  • Phone: 888-267-9095
  • Fax:
Mailing address:
  • Phone: 917-710-6188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number07544
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number054801
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: