MEDICARE: SEYONG CHOI PHYSICAL THERAPY INC

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	225100000X	Physical Therapist	PT9713	CA

General Provider Information

NPI Number	:	1346347259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEYONG CHOI PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	3545 WILSHIRE BLVD SUITE 245
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2389
Country	:	US
Telephone Number	:	213-487-5176
Fax Number	:	213-487-5177

Provider Business Practice Location Address
First Line	:	3545 WILSHIRE BLVD SUITE 245
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2389
Country	:	US
Telephone Number	:	213-487-5176
Fax Number	:	213-487-5177

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SE YONG CHOI
Credential	:	PT
Telephone Number	:	213-487-5176

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	04/26/2018

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