Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 39139 | CA |
NPI | 1033194741 |
---|---|
Provider Name | Dr. James Changwon Choi |
First Address | Apo, AE 09461-5115 |
Second Address | Fairfield, CA 94535-1800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 19/05/2020 |