Provider Demographics
NPI:1629377692
Name:ALLEN CHOI, O.D., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ALLEN CHOI, O.D., A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-521-1133
Mailing Address - Street 1:5300 BEACH BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1297
Mailing Address - Country:US
Mailing Address - Phone:714-521-1133
Mailing Address - Fax:714-521-1131
Practice Address - Street 1:5300 BEACH BLVD STE 114
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-1297
Practice Address - Country:US
Practice Address - Phone:714-521-1133
Practice Address - Fax:714-521-1131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15393152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty