Provider Demographics
NPI:1053590208
Name:HICHANG CHOI, M.D., INC.
Entity type:Organization
Organization Name:HICHANG CHOI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HICHANG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-865-5121
Mailing Address - Street 1:12229 ARTESIA BLVD
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-8143
Mailing Address - Country:US
Mailing Address - Phone:562-865-5121
Mailing Address - Fax:562-865-2321
Practice Address - Street 1:12229 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-8143
Practice Address - Country:US
Practice Address - Phone:562-865-5121
Practice Address - Fax:562-865-2321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75490207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19291Medicare UPIN