Healthcare Provider Details

I. General information

NPI: 1851112452
Provider Name (Legal Business Name): ERIC WOORIM CHOI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 09/10/2026
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E TACHEVAH DR STE 2W203
PALM SPRINGS CA
92262-5761
US

IV. Provider business mailing address

10216 CARTAGENA DR
MORENO VALLEY CA
92557-9021
US

V. Phone/Fax

Practice location:
  • Phone: 760-561-7373
  • Fax:
Mailing address:
  • Phone: 951-529-6865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number88278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: