Healthcare Provider Details

I. General information

NPI: 1700241387
Provider Name (Legal Business Name): JINAH KIM CHOI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 09/20/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4733 TORRANCE BLVD # 208
TORRANCE CA
90503-4100
US

IV. Provider business mailing address

4733 TORRANCE BLVD # 208
TORRANCE CA
90503-4100
US

V. Phone/Fax

Practice location:
  • Phone: 213-215-5325
  • Fax:
Mailing address:
  • Phone: 213-215-5325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number830045
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95016842
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: