MEDICARE: WONSICK CHOE

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	207U00000X	Nuclear Medicine Physician	C42362	CA
2	208D00000X	General Practice Physician	C42362	CA

General Provider Information

NPI Number	:	1689070690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WONSICK CHOE

Provider Business Mailing Address
First Line	:	PO BOX 32039
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90032-0039
Country	:	US
Telephone Number	:	323-517-1274
Fax Number	:	323-612-6297

Provider Business Practice Location Address
First Line	:	20627 GOLDEN SPRINGS DR STE 1B
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-4815
Country	:	US
Telephone Number	:	909-480-0200
Fax Number	:	909-480-0201

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

Provider Enumeration Date	:	11/18/2014
Last Update Date	:	01/05/2026

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Directions to “ WONSICK CHOE ” Practice Location

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