Active NPI
Johnny Jaehwan Choi, M.D.
- Internal Medicine Physician
- Upland, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A97680
- Practice address
- 141 W Foothill Blvd
Upland, CA 91786-8705 - Phone
- (909) 296-8800
- NPI assigned
- Sep 20, 2006
- Last updated
- Aug 30, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 222248 | MA | |
| Internal Medicine Physician | 207R00000X | A97680 | CA | Primary |
Addresses
Primary practice location
141 W Foothill Blvd
Upland, CA 91786-8705
Mailing address
12900 Park Plaza Dr Ste 150
Cerritos, CA 90703-9329
Phone (562) 977-4639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Tufts University School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12740 Hesperia Rd
Suite a
Victorville, CA 92395-8306
Phone (760) 713-6969
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A97680 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shima Hadidchi MD a Professional Corp | Current | Accepting new patients | |
| Lakeside Medical Organization, a Medical Group Inc. | Internal Medicine | Current | Accepting new patients |
| Caremore Health Plan | Past | Accepting new patients | |
| Caremore Medical Group Inc | Internal Medicine | Past | Accepting new patients |
| Lakeside Medical Associates, a Medical Group, Inc. | Past | Accepting new patients | |
| Heritage Provider Network, Inc. | Past | Accepting new patients |
Locations
1500 S Central Ave
Ste 200
Glendale, CA 91204
Phone (818) 242-8916
8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000
12740 Hesperia Rd
Ste A
Victorville, CA 92395
Phone (760) 713-6969
12740 Hesperia Rd
Ste B
Victorville, CA 92395
Phone (760) 713-6969
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EECJBD
- johnny.choi.p1@direct.lakeside.nextgenshare.com
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Victorville, CA
- NPI 1295165645
-
- Internal Medicine Physician
- West Hills, CA
- NPI 1831426642
-
- Family Medicine Physician
- Victorville, CA
- NPI 1225685332
-
- Family Nurse Practitioner
- Upland, CA
- NPI 1467825901
-
- Health Maintenance Organization
- Northridge, CA
- NPI 1881720001
-
dba Lakeside Community Healthcare Medical Group
- Rheumatology Physician
- Burbank, CA
- NPI 1861499535
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Hollywood Presbyterian Medical Center
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1922033547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567123200000",
"number": "1376640714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12900 PARK PLAZA DR STE 150",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907039329",
"telephone_number": "562-977-4639",
"fax_number": "562-741-4479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 W FOOTHILL BLVD",
"city": "UPLAND",
"state": "CA",
"postal_code": "917868705",
"telephone_number": "909-296-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOI",
"first_name": "JOHNNY",
"middle_name": "JAEHWAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2019-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "222248",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A97680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.