Provider Demographics
NPI:1043023351
Name:BUNG JOO CHOI PHYSICIAN ASSISTANT PC
Entity type:Organization
Organization Name:BUNG JOO CHOI PHYSICIAN ASSISTANT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BUNG JOO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:404-433-3737
Mailing Address - Street 1:20556 W DEER GRASS CT
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4990
Mailing Address - Country:US
Mailing Address - Phone:404-433-3737
Mailing Address - Fax:
Practice Address - Street 1:20556 W DEER GRASS CT
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-4990
Practice Address - Country:US
Practice Address - Phone:404-433-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty