Organization Active NPI

Joon Choi MD a Professional Corporation

  • Obstetrics & Gynecology Physician
  • Glendale, CA
National Provider Identifier
1821278771
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G80351 Issued in CA
Legal business name
JOON CHOI MD A PROFESSIONAL CORPORATION
Practice address
1577 E Chevy Chase Dr
110
Glendale, CA 91206-4172
Phone
(818) 242-6811
Fax
(818) 242-1401
NPI assigned
Nov 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Authorized official

Name
Joon ChoiNPI 1023073152
Title
Ceo
Phone
(818) 242-6811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X G80351 CA Primary

Addresses

Primary practice location

1577 E Chevy Chase Dr
110
Glendale, CA 91206-4172

Mailing address

1577 E Chevy Chase Dr
110
Glendale, CA 91206-4172
Phone (818) 242-6811

Other identifiers 1

IdentifierTypeStateIssuer
00G803510MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121102000258 CA Part B Supplier - Clinic/Group Practice 9830340629 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Panorama City, CA; Sun Valley, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

8215 Van Nuys Blvd
Ste 104
Panorama City, CA 91402
Phone (818) 994-4010

8215 Van Nuys Blvd
Van Nuys, CA 91402
Phone (818) 855-2270

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1821278771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1577 E CHEVY CHASE DR",
            "address_2": "110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064172",
            "telephone_number": "818-242-6811",
            "fax_number": "818-242-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 E CHEVY CHASE DR",
            "address_2": "110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064172",
            "telephone_number": "818-242-6811",
            "fax_number": "818-242-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOON CHOI MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "JOON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-242-6811"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G80351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G803510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.