Provider Demographics
NPI:1275090805
Name:WON, CHRISTOPHER CHOY
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CHOY
Last Name:WON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9609 ARELLANO CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4147
Mailing Address - Country:US
Mailing Address - Phone:510-304-3651
Mailing Address - Fax:
Practice Address - Street 1:1057 N 1ST ST
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:CA
Practice Address - Zip Code:95620-2428
Practice Address - Country:US
Practice Address - Phone:707-678-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist