=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871610097
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAVLINA BOSHKOVA CHOYKOVA DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2007
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 808 W 58TH ST
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90037-3632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-541-1600
-----------------------------------------------------
Fax | 323-541-1499
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5640 WILHELMINA AVE
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91367
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-917-0861
-----------------------------------------------------
Fax | 818-888-0496
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 49498
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------