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General NPI Number Information
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NPI Number | 1750309027
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Entity Type | Individual
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Provider Name | RANDY CHOI P.A.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 1030 S GLENDALE AVE STE 200
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City | GLENDALE
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State | CA
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Zip | 91205-2866
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Country | US
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Telephone | 626-375-9602
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Fax | 626-657-2695
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Provider Business Mailing Address
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Address Line | PO BOX 70574
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City | PASADENA
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State | CA
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Zip | 91117-7574
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Country | US
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Telephone | 626-375-9602
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Fax | 626-657-2695
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 15088
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License Number State | CA
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