Provider Demographics
NPI:1386363141
Name:CHOI, DASOL (PHARMD)
Entity type:Individual
Prefix:
First Name:DASOL
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 MIRACLE MILE
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-7505
Mailing Address - Country:US
Mailing Address - Phone:928-758-2212
Mailing Address - Fax:
Practice Address - Street 1:2350 MIRACLE MILE
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7505
Practice Address - Country:US
Practice Address - Phone:928-758-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2023-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04271500183500000X
NY071028183500000X
AZS025990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist