Provider Demographics
NPI:1679650675
Name:CHOI, MYUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:MYUNG
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAUL MYUNG-GI
Other - Middle Name:
Other - Last Name:CHOI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:266 S HARVARD BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-4372
Mailing Address - Country:US
Mailing Address - Phone:213-387-9000
Mailing Address - Fax:213-387-5804
Practice Address - Street 1:266 S HARVARD BLVD STE 250
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004
Practice Address - Country:US
Practice Address - Phone:213-387-9000
Practice Address - Fax:213-387-5804
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76636174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE71536Medicare UPIN