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General NPI Number Information
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NPI Number | 1942933395
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Entity Type | Individual
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Provider Name | ELLIN JINSUN CHOI DDS
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Gender | Female
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Dates
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Enumeration Date | 07/04/2022
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 2862 CANYON SPRINGS PKWY UNIT A
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City | RIVERSIDE
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State | CA
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Zip | 92507-0928
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Country | US
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Telephone | 951-300-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 TRABUCO RD APT 422
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City | IRVINE
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State | CA
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Zip | 92620-5794
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Country | US
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Telephone | 714-788-6549
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 106035
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License Number State | CA
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