Provider Demographics
NPI:1205292711
Name:DR MARTIN CHOI INCORPORATED
Entity type:Organization
Organization Name:DR MARTIN CHOI INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-755-0889
Mailing Address - Street 1:2334 CARMEL VALLEY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3754
Mailing Address - Country:US
Mailing Address - Phone:858-755-0889
Mailing Address - Fax:858-755-6618
Practice Address - Street 1:2334 CARMEL VALLEY RD
Practice Address - Street 2:SUITE B
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3754
Practice Address - Country:US
Practice Address - Phone:858-755-0889
Practice Address - Fax:858-755-6618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherWC