MEDICARE: MICHAEL 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	17278	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17278	OTHER	NV	BOARD OF PHARMACY

General Provider Information

NPI Number	:	1619599149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CHOI PHARM.D.

Provider Business Mailing Address
First Line	:	312 LORELEI ROCK ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-3015
Country	:	US
Telephone Number	:	949-436-1353
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 LORELEI ROCK ST # 31
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-3015
Country	:	US
Telephone Number	:	949-436-1353
Fax Number	:

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

Provider Enumeration Date	:	05/06/2020
Last Update Date	:	05/06/2020

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Directions to “ MICHAEL CHOI PHARM.D.” Practice Location

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