Provider Demographics
NPI:1083714448
Name:CHOI, SANG H (MD)
Entity Type:Individual
Prefix:MR
First Name:SANG
Middle Name:H
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NORTH VERMONT AVENUE
Mailing Address - Street 2:DOCTOR'S TOWER, SUITE 100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:323-484-4350
Mailing Address - Fax:323-913-4351
Practice Address - Street 1:1300 NORTH VERMONT AVENUE
Practice Address - Street 2:DOCTOR'S TOWER, SUITE 100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-484-4350
Practice Address - Fax:323-913-4351
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301038133208600000X
CAA39749208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIAC8371976OtherDRUG ENFORCEMENT ADMIN.
AC8371976OtherDEA
MIAC8371976OtherDRUG ENFORCEMENT ADMIN.