Provider Demographics
NPI:1386798395
Name:GEORGE C CHOI PSYD & WENDY H CHOI PSYD INC
Entity type:Organization
Organization Name:GEORGE C CHOI PSYD & WENDY H CHOI PSYD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-243-2218
Mailing Address - Street 1:1885 MAIN ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793
Mailing Address - Country:US
Mailing Address - Phone:858-243-2218
Mailing Address - Fax:808-249-0223
Practice Address - Street 1:1885 MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793
Practice Address - Country:US
Practice Address - Phone:858-243-2218
Practice Address - Fax:808-249-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY436103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07257701Medicaid