Basic Information
Provider Information
NPI: 1831527431
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOI
FirstName: SARAH
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4140 W 190TH ST
Address2:  
City: TORRANCE
State: CA
PostalCode: 905045513
CountryCode: US
TelephoneNumber:  
FaxNumber: 3109671773
Practice Location
Address1: 8700 BEVERLY BLVD
Address2:  
City: WEST HOLLYWOOD
State: CA
PostalCode: 900481804
CountryCode: US
TelephoneNumber: 3104232331
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/17/2013
LastUpdateDate: 02/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X017125NYN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363AS0400X  N Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
363AS0400XPA53831CAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical

No ID Information.


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