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NPI Code Detail

MEDICARE: DR. SUNWOONG STEVE CHOI DDS, MD

MEDICARE: DR. SUNWOONG STEVE CHOI DDS, 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
11223G0001XGeneral Practice Dentistry30022305OH
21223S0112XOral and Maxillofacial Surgery (Dentist)59175CA

General Provider Information

NPI Number : 1457435588
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUNWOONG STEVE CHOI DDS, MD
Provider Business Mailing Address
First Line : 15260 FAIRGROVE AVE
Second Line :
City : LA PUENTE
State : CA
Zip : 91744-1067
Country : US
Telephone Number : 323-459-9609
Fax Number : 626-917-1783
Provider Business Practice Location Address
First Line : 12121 WILSHIRE BLVD STE 1111
Second Line : FRONTIER DENTAL MANAGEMENT
City : LOS ANGELES
State : CA
Zip : 90025-1188
Country : US
Telephone Number : 310-820-9933
Fax Number : 310-820-0408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 07/20/2010

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