Basic Information
Provider Information
NPI: 1649568007
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOI
FirstName: JOON
MiddleName: HWAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16955 VIA DEL CAMPO STE 215
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921277720
CountryCode: US
TelephoneNumber: 8586736100
FaxNumber:  
Practice Location
Address1: 2185 CITRACADO PKWY
Address2:  
City: ESCONDIDO
State: CA
PostalCode: 920294159
CountryCode: US
TelephoneNumber: 4422815000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/19/2011
LastUpdateDate: 09/14/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X25MA09339100NJN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000X264670-1NYN Allopathic & Osteopathic PhysiciansAnesthesiology 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207L00000XA124475CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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