MEDICARE: SUSAN CHOI PHARM. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	49710	CA

General Provider Information

NPI Number	:	1104109271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN CHOI PHARM. D.

Provider Business Mailing Address
First Line	:	845 PACIFIC COAST HWY
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-3915
Country	:	US
Telephone Number	:	310-798-5400
Fax Number	:	310-798-5448

Provider Business Practice Location Address
First Line	:	845 PACIFIC COAST HWY
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-3915
Country	:	US
Telephone Number	:	310-798-5400
Fax Number	:	310-798-5448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2011
Last Update Date	:	07/12/2013

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