Healthcare Provider Details

I. General information

NPI: 1780547059
Provider Name (Legal Business Name): SUNG JIN CHOI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 CANAL BLVD
RICHMOND CA
94804-3549
US

IV. Provider business mailing address

1007 CANAL BLVD
RICHMOND CA
94804-3549
US

V. Phone/Fax

Practice location:
  • Phone: 925-922-1799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License Number58391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: