MEDICARE: SOON A CHOI 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	207R00000X	Internal Medicine Physician	145562	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C1676	OTHER	MI	MCARE
2	1102525771	OTHER	MI	BLUE CROSS BLUE SHIELD
3	110B510530	OTHER	MI	BLUE CARE NETWORK
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	E49693	OTHER	MA	HEALTH NET FEDERAL
6	110B510530	OTHER	MI	BLUE CROSS POINT OF SERVI
7	110B510530	OTHER	MI	COMMUNITY BLUE
8	204371	OTHER	MI	MCLAREN HEALTH PLAN
9	4464705	OTHER	MI	AETNA
10	8388337001	OTHER	MI	CIGNA
11	110134957	OTHER	MI	METRAHEALTH
12	110B510530	OTHER	MI	BLUE CROSS BLUE SHIELD
13	204371	OTHER	MI	HEALTH ADVANTAGE NETWORK
14	E49693	OTHER	MI	HEALTH ALLIANCE PLAN

General Provider Information

NPI Number	:	1821088162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOON A CHOI MD

Provider Business Mailing Address
First Line	:	3663 W 6TH ST
Second Line	:	STE 106
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-3047
Country	:	US
Telephone Number	:	213-388-1111
Fax Number	:	213-637-4755

Provider Business Practice Location Address
First Line	:	2420 OWEN RD
Second Line	:
City	:	FENTON
State	:	MI
Zip	:	48430-3417
Country	:	US
Telephone Number	:	810-342-1000
Fax Number	:	810-342-1590

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	11/16/2016

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Directions to “ SOON A CHOI MD” Practice Location

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