Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | A96058 | CA |
NPI | 1306124037 |
---|---|
Provider Name | Meeryo Christa Choe |
First Address | Chatsworth, CA 91311 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2011 |
Last Update Date | 14/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A960580 | (05) | CA |
1306124037 | MEDI CAL (01) | CA |