Healthcare Provider Details

I. General information

NPI: 1619592623
Provider Name (Legal Business Name): LORENZ CHOI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HILLMONT AVE STE 101
VENTURA CA
93003-1651
US

IV. Provider business mailing address

142 BOND ST
BROOKLYN NY
11217-2242
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6100
  • Fax:
Mailing address:
  • Phone: 845-893-2681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number23788
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: