Provider Demographics
NPI:1245273820
Name:CHOI, EDWIN H (MD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:H
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:866 S. WESTMORELAND AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005
Mailing Address - Country:US
Mailing Address - Phone:800-821-5675
Mailing Address - Fax:213-289-1166
Practice Address - Street 1:866 S WESTMORELAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-2372
Practice Address - Country:US
Practice Address - Phone:800-821-5675
Practice Address - Fax:213-315-5195
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54943207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A549430Medicaid
CAH44052Medicare UPIN
CA00A549430Medicaid