Provider Demographics
NPI:1619096724
Name:CHOI, MARTIN W (DC)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:W
Last Name:CHOI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:MARTIN
Other - Middle Name:
Other - Last Name:CHOI, INC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2334 CARMEL VALLEY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3754
Mailing Address - Country:US
Mailing Address - Phone:858-829-2118
Mailing Address - Fax:858-755-6618
Practice Address - Street 1:2334 CARMEL VALLEY RD
Practice Address - Street 2:SUITE B
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3754
Practice Address - Country:US
Practice Address - Phone:858-829-2118
Practice Address - Fax:858-755-6618
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
095601QPXMedicare PIN