Provider Demographics
NPI:1033498936
Name:CHOI, DALE (OD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3524 TORRANCE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4821
Mailing Address - Country:US
Mailing Address - Phone:310-316-2055
Mailing Address - Fax:310-316-2058
Practice Address - Street 1:946 MANHATTAN BEACH BLVD
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5120
Practice Address - Country:US
Practice Address - Phone:310-545-4585
Practice Address - Fax:888-753-1007
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 14202 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL573ZMedicare PIN