Provider Demographics
NPI:1295758639
Name:T.H. CHOI, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:T.H. CHOI, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOON-JI
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-881-3922
Mailing Address - Street 1:7862 SQUAW VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7843
Mailing Address - Country:US
Mailing Address - Phone:562-881-3922
Mailing Address - Fax:425-928-4044
Practice Address - Street 1:3772 KATELLA AVE STE 107
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-6424
Practice Address - Country:US
Practice Address - Phone:562-431-7877
Practice Address - Fax:562-431-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207P00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16848Medicare PIN