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General NPI Number Information
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NPI Number | 1043023351
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Entity Type | Organization
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Legal Business Name | BUNG JOO CHOI PHYSICIAN ASSISTANT PC
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 20556 W DEER GRASS CT
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City | PORTER RANCH
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State | CA
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Zip | 91326-4990
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Country | US
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Telephone | 404-433-3737
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Fax |
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Provider Business Mailing Address
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Address Line | 20556 W DEER GRASS CT
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City | PORTER RANCH
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State | CA
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Zip | 91326-4990
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Country | US
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Telephone | 404-433-3737
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BUNG JOO CHOI
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Credential | PA
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Telephone | 404-433-3737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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