Provider Demographics
NPI:1568443166
Name:CHOO, PHILLIP HYUNCHUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:HYUNCHUL
Last Name:CHOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 CENTRE AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3761
Mailing Address - Country:US
Mailing Address - Phone:412-681-4220
Mailing Address - Fax:412-681-4396
Practice Address - Street 1:5750 CENTRE AVE STE 230
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3761
Practice Address - Country:US
Practice Address - Phone:412-681-4220
Practice Address - Fax:412-681-4396
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG082078207WX0200X
PAMD052945L207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017905690001Medicaid
PAMD052945LOtherSTATE MEDICAL LICENSE NUM
PA428605GNZMedicare PIN
PAF87902Medicare UPIN