Provider Demographics
NPI:1932135746
Name:CHOI, SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 OAK GROVE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2536
Mailing Address - Country:US
Mailing Address - Phone:925-296-7156
Mailing Address - Fax:925-296-7174
Practice Address - Street 1:2125 OAK GROVE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2536
Practice Address - Country:US
Practice Address - Phone:925-296-7156
Practice Address - Fax:925-296-7174
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG659252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD71590Medicare UPIN
CA00G659257Medicare PIN
CA300097027Medicare PIN
CA00G659250Medicare PIN
CA00G6592513Medicare PIN
CA00G6592519Medicare PIN
CA00G659253Medicare PIN
CA00G659256Medicare PIN
CA00G659259Medicare PIN
CA00G659251Medicare PIN
CA00G6592511Medicare PIN
CA00G6592512Medicare PIN
CA00G6592515Medicare PIN
CA00G659252Medicare PIN
CA00G6592517Medicare PIN
CA00G6592521Medicare PIN
CA300096982Medicare PIN
CA00G6592514Medicare PIN
CA00G6592516Medicare PIN
CA00G659254Medicare PIN
CA300085403Medicare PIN
CA00G6592510Medicare PIN
CA00G6592520Medicare PIN
CA00G659255Medicare PIN
CA00G659258Medicare PIN