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General NPI Number Information
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NPI Number | 1114646940
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Entity Type | Organization
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Legal Business Name | CHOI DDS WC1, PC
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 649 W IMPERIAL HWY STE H
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City | BREA
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State | CA
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Zip | 92821-3838
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Country | US
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Telephone | 714-529-1232
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Fax | 714-529-1208
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Provider Business Mailing Address
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Address Line | 649 W IMPERIAL HWY STE H
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City | BREA
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State | CA
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Zip | 92821-3838
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Country | US
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Telephone | 714-529-1232
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Fax | 714-529-1208
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Authorized Official
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Title or Position | MANAGER
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Name | CHRIS CHONG
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Credential |
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Telephone | 626-373-3625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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