Provider Demographics
NPI:1801384557
Name:CHOI, JI YOUNG
Entity Type:Individual
Prefix:
First Name:JI YOUNG
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 W RANCHO VISTA BLVD
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-2572
Mailing Address - Country:US
Mailing Address - Phone:661-202-3604
Mailing Address - Fax:661-202-3603
Practice Address - Street 1:3875 W RANCHO VISTA BLVD
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-2572
Practice Address - Country:US
Practice Address - Phone:661-202-3604
Practice Address - Fax:661-202-3603
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist