Healthcare Provider Details

I. General information

NPI: 1003184680
Provider Name (Legal Business Name): STEPHEN SUNGDUK CHOI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18560 STONEGATE LN
ROWLAND HEIGHTS CA
91748-5169
US

IV. Provider business mailing address

8221 N FRESNO ST
FRESNO CA
93720-2041
US

V. Phone/Fax

Practice location:
  • Phone: 800-242-0880
  • Fax: 562-697-3950
Mailing address:
  • Phone: 800-242-0880
  • Fax: 559-492-5636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC50603
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: