Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 50 053256 | NY |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | OMS102 | CA |
N | 204E00000X | Oral & Maxillofacial Surgeon | 60 257968 | NY |
N | 208200000X | Surgeon | A124593 | CA |
N | 208600000X | Surgeon | A124593 | CA |
NPI | 1326214941 |
---|---|
Provider Name | Dr. Christopher Choi |
First Address | Rancho Cucamonga, CA 91730-7471 |
Second Address | Rancho Cucamonga, CA 91730-7471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2008 |
Last Update Date | 06/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02866815 | (05) | NY |