Healthcare Provider Details

I. General information

NPI: 1376051847
Provider Name (Legal Business Name): GLORIA LEE CHOI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date: 08/16/2018
Reactivation Date: 07/29/2026

III. Provider practice location address

11000 VENTURA BLVD
STUDIO CITY CA
91604
US

IV. Provider business mailing address

11000 VENTURA BLVD
STUDIO CITY CA
91604
US

V. Phone/Fax

Practice location:
  • Phone: 818-761-6563
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number74686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: