Provider Demographics
NPI:1114682622
Name:CHOI, HEIDI HAYOUNG (PHARM D)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:HAYOUNG
Last Name:CHOI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2713
Mailing Address - Country:US
Mailing Address - Phone:619-615-0726
Mailing Address - Fax:619-739-4180
Practice Address - Street 1:1850 5TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2713
Practice Address - Country:US
Practice Address - Phone:619-615-0726
Practice Address - Fax:619-739-4180
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist