Provider Demographics
NPI:1194826024
Name:CHOV, HOEUNG MOEUNG (DPM)
Entity Type:Individual
Prefix:DR
First Name:HOEUNG
Middle Name:MOEUNG
Last Name:CHOV
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40494
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90239-1494
Mailing Address - Country:US
Mailing Address - Phone:626-497-3300
Mailing Address - Fax:
Practice Address - Street 1:11003 LAKEWOOD BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3809
Practice Address - Country:US
Practice Address - Phone:562-869-3668
Practice Address - Fax:562-869-8409
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4267213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E42671Medicaid
CABW217ZMedicare PIN
U74739Medicare UPIN
CA000E42671Medicaid