Provider Demographics
NPI:1083810246
Name:KELVIN C. CHOI, D.D.S., INC
Entity Type:Organization
Organization Name:KELVIN C. CHOI, D.D.S., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KELVIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-871-1400
Mailing Address - Street 1:2400 WESTBOROUGH BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-5404
Mailing Address - Country:US
Mailing Address - Phone:650-871-1400
Mailing Address - Fax:650-871-5541
Practice Address - Street 1:2400 WESTBOROUGH BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5404
Practice Address - Country:US
Practice Address - Phone:650-871-1400
Practice Address - Fax:650-871-5541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA268221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty