Healthcare Provider Details

I. General information

NPI: 1750920609
Provider Name (Legal Business Name): EMILY J CHOI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 DOLORES AVE
SAN LEANDRO CA
94577-5007
US

IV. Provider business mailing address

201 DOLORES AVE
SAN LEANDRO CA
94577-5007
US

V. Phone/Fax

Practice location:
  • Phone: 510-984-2489
  • Fax: 510-788-6830
Mailing address:
  • Phone: 510-984-2489
  • Fax: 510-788-6830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number64729
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: