Healthcare Provider Details

I. General information

NPI: 1083142269
Provider Name (Legal Business Name): KEVIN CHOI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 GREENLEAF AVE STE C
WHITTIER CA
90602-1373
US

IV. Provider business mailing address

13346 CHASE ST
ARLETA CA
91331-5719
US

V. Phone/Fax

Practice location:
  • Phone: 562-945-1684
  • Fax:
Mailing address:
  • Phone: 818-671-7268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number102542
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: