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General NPI Number Information
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NPI Number | 1144501891
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Entity Type | Individual
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Provider Name | SOO KYUNG CHOI
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Gender | Female
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 820 SIR FRANCIS DRAKE BLVD
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City | SAN ANSELMO
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State | CA
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Zip | 94960-1906
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Country | US
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Telephone | 415-482-0191
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Fax |
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Provider Business Mailing Address
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Address Line | 20 GREEN WAY APT 6
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City | SAN RAFAEL
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State | CA
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Zip | 94901-5732
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Country | US
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Telephone | 415-754-5380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 65356
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License Number State | CA
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