Kang Won Choi, D.O.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

20A12512 Issued in CA

Practice address

31946 Mission TRL Ste B
Lake Elsinore, CA 92530-4539

Phone

(951) 245-7663

NPI assigned

May 10, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: kchoi134105@direct.llu.edu

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1457643355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31946 MISSION TRL STE B",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304539",
            "telephone_number": "951-245-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31946 MISSION TRL STE B",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304539",
            "telephone_number": "951-245-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "KANG WON",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "20A12512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flor Checa
• Eileen Cheng, OD
• Patrick Chern, PHARM.D
• Christine Choe
• Benedict W Choi
• Michael Andrew Chow, MAOM, LAC
• Camara Nicole Christian
• Iliam Amalia Cisneros
• Guadalupe Clardy, AMFT, APCC
• Natalie Nicole Clark

• Child & Adolescent Psychiatry Physician in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.