Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 37320 | CA |
NPI | 1073094652 |
---|---|
Provider Name | Dr. David Phoon Choe |
First Address | Cerritos, CA 90703-6379 |
Second Address | Irvine, CA 92618-3176 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2018 |
Last Update Date | 22/08/2018 |