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General NPI Number Information
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NPI Number | 1588077945
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Entity Type | Individual
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Provider Name | MIKE CHOI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 699 HAMPSHIRE RD STE 209
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-2351
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Country | US
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Telephone | 805-494-4887
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Fax |
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Provider Business Mailing Address
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Address Line | 699 HAMPSHIRE RD STE 209
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-2351
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Country | US
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Telephone | 805-494-4887
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 52046
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License Number State | CA
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