Provider Demographics
NPI:1407176449
Name:CHOI, IN WOOK H (RPH)
Entity Type:Individual
Prefix:MRS
First Name:IN WOOK
Middle Name:H
Last Name:CHOI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 CANYON PARK DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2801
Mailing Address - Country:US
Mailing Address - Phone:909-861-1650
Mailing Address - Fax:
Practice Address - Street 1:401 W IMPERIAL HWY
Practice Address - Street 2:RITE AID
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4818
Practice Address - Country:US
Practice Address - Phone:714-529-2176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH44262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist