Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A156572 | CA |
N | 207YP0228X | Pediatric Otolaryngology | A156572 | CA |
NPI | 1134486681 |
---|---|
Provider Name | Dr. Kevin Jae Choi |
First Address | Los Angeles, CA 90006-1014 |
Second Address | Los Angeles, CA 90006-1014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2012 |
Last Update Date | 29/07/2020 |