Provider Demographics
NPI:1013917046
Name:CHOI, SUNG WHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNG
Middle Name:WHAN
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2299 SACRAMENTO ST
Mailing Address - Street 2:APT. 3
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2340 CLAY ST
Practice Address - Street 2:SUITE 525
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1932
Practice Address - Country:US
Practice Address - Phone:415-600-1099
Practice Address - Fax:415-600-1097
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA88258207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3196127Medicaid
CA3196127Medicaid
A29403Medicare ID - Type Unspecified
110185761Medicare ID - Type Unspecified