Provider Demographics
NPI:1801904461
Name:THOMAS CHOC-HO LEE DDS MS INC
Entity type:Organization
Organization Name:THOMAS CHOC-HO LEE DDS MS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHOC-HO
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:805-278-4048
Mailing Address - Street 1:1801 SOLAR DRIVE
Mailing Address - Street 2:155
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030
Mailing Address - Country:US
Mailing Address - Phone:805-278-4048
Mailing Address - Fax:805-278-4043
Practice Address - Street 1:1801 SOLAR DRIVE
Practice Address - Street 2:155
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030
Practice Address - Country:US
Practice Address - Phone:805-278-4048
Practice Address - Fax:805-278-4043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46858122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G9273701Medicare UPIN