MEDICARE: SUNG M CHOE M.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	2088P0231X	Pediatric Urology Physician	G60484	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ZZZ07538Z	OTHER	CA	BLUE SHIELD ID #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326041427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNG M CHOE M.D.

Provider Business Mailing Address
First Line	:	421 E MERCED AVE
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91790
Country	:	US
Telephone Number	:	626-918-1881
Fax Number	:	626-918-3618

Provider Business Practice Location Address
First Line	:	421 E MERCED AVE
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91790
Country	:	US
Telephone Number	:	626-918-1881
Fax Number	:	626-918-3618

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/07/2023

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Directions to “ SUNG M CHOE M.D.” Practice Location

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