Provider Demographics
NPI:1770644452
Name:CHOI, MIRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRAN
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2625 ALCATRAZ AVE # 196
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2702
Mailing Address - Country:US
Mailing Address - Phone:510-684-6834
Mailing Address - Fax:510-849-1495
Practice Address - Street 1:2305 ASHBY AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1909
Practice Address - Country:US
Practice Address - Phone:510-684-6834
Practice Address - Fax:510-849-1495
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA846212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry