Provider Demographics
NPI:1386602720
Name:CHOI, BRIAN S (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:S
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4500 BROCKTON AVE
Mailing Address - Street 2:STE 107
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-4006
Mailing Address - Country:US
Mailing Address - Phone:714-698-0300
Mailing Address - Fax:714-698-0303
Practice Address - Street 1:4500 BROCKTON AVENUE
Practice Address - Street 2:STE. #107
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501
Practice Address - Country:US
Practice Address - Phone:951-276-2760
Practice Address - Fax:951-276-2960
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA104454174400000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist