Provider Demographics
NPI:1821032889
Name:MAK, PATTIE CHI CHOY (WH NP-BC)
Entity Type:Individual
Prefix:
First Name:PATTIE
Middle Name:CHI CHOY
Last Name:MAK
Suffix:
Gender:F
Credentials:WH NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 S SAN GABRIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-2847
Mailing Address - Country:US
Mailing Address - Phone:626-286-8700
Mailing Address - Fax:626-286-8650
Practice Address - Street 1:923 S SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2847
Practice Address - Country:US
Practice Address - Phone:626-286-8700
Practice Address - Fax:626-286-8650
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7134363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA463716OtherBOARD REGISTERED NURSING