Healthcare Provider Details

I. General information

NPI: 1215686167
Provider Name (Legal Business Name): JOHN H CHOE PMNHP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2022
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BARRANCA ST STE 130
WEST COVINA CA
91791-1637
US

IV. Provider business mailing address

12540 MOUNT HOLLY DR
WHITTIER CA
90601-2456
US

V. Phone/Fax

Practice location:
  • Phone: 626-433-1311
  • Fax:
Mailing address:
  • Phone: 562-652-0939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95144162
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95020693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: