Provider Demographics
NPI:1457344111
Name:Y.C. CHOO, M.D., P.C.
Entity Type:Organization
Organization Name:Y.C. CHOO, M.D., P.C.
Other - Org Name:Y.C. CHOO, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YEW
Authorized Official - Middle Name:CHEONG
Authorized Official - Last Name:CHOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-747-6100
Mailing Address - Street 1:3020 S HARVARD AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-6126
Mailing Address - Country:US
Mailing Address - Phone:918-747-6100
Mailing Address - Fax:918-747-0402
Practice Address - Street 1:3020 S HARVARD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-6126
Practice Address - Country:US
Practice Address - Phone:918-747-6100
Practice Address - Fax:918-747-0402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-29
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14935207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119073001Medicaid
OK100629080BMedicaid
OKC14463Medicare UPIN
AR119073001Medicaid
OK400522137Medicare ID - Type UnspecifiedGROUP ID NUMBER
OK100629080BMedicaid