Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 0101252858 | VA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 2006-01320 | NC |
N | 207QG0300X | Family Doctor - Geriatric Medicine | A92152 | CA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | D0081318 | MD |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MD040643 | DC |
NPI | 1225149859 |
---|---|
Provider Name | Jiho Choi |
First Address | Annandale, VA 22003-3256 |
Second Address | Annandale, VA 22003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 09/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1225149859 | (05) | VA |