Provider Demographics
NPI:1770695546
Name:CHOI, WESLEY WON-SUK (MD)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:WON-SUK
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 CORTE VENOSA
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-1680
Mailing Address - Country:US
Mailing Address - Phone:323-251-1636
Mailing Address - Fax:
Practice Address - Street 1:1304 CORTE VENOSA
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1680
Practice Address - Country:US
Practice Address - Phone:323-251-1636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88259208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology