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1457338162

NPI Code Detail

MEDICARE: ROBERT CHOI KWUN MD

MEDICARE: ROBERT CHOI KWUN MD

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	207W00000X	Ophthalmology Physician	3082804-1205	UT
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	3082804-1205	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	180040257	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	870525682	OTHER		TAX ID #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457338162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT CHOI KWUN MD

Provider Business Mailing Address
First Line	:	5169 COTTONWOOD ST STE 630
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-6771
Country	:	US
Telephone Number	:	801-281-3030
Fax Number	:	801-281-3033

Provider Business Practice Location Address
First Line	:	5169 COTTONWOOD ST STE 630
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-6771
Country	:	US
Telephone Number	:	801-281-3030
Fax Number	:	801-281-3033

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

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	02/22/2018

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Directions to “ ROBERT CHOI KWUN MD” Practice Location

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