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General NPI Number Information
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NPI Number | 1902006745
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Entity Type | Organization
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Legal Business Name | LUKE K. CHOI, DDS, MS, INC.
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 15862 IMPERIAL HWY
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City | LA MIRADA
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State | CA
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Zip | 90638-2512
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Country | US
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Telephone | 562-947-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 15862 IMPERIAL HWY
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City | LA MIRADA
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State | CA
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Zip | 90638-2512
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Country | US
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Telephone | 562-947-9500
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. LUKE KYOUNG GOO CHOI
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Credential | DDS
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Telephone | 562-947-9500
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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 | 34316
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License Number State | CA
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