Provider Demographics
NPI:1992504591
Name:CHOI, MINHO (RD)
Entity type:Individual
Prefix:
First Name:MINHO
Middle Name:
Last Name:CHOI
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 BERTONICO AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-1828
Mailing Address - Country:US
Mailing Address - Phone:626-629-6977
Mailing Address - Fax:
Practice Address - Street 1:3205 BERTONICO AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-1828
Practice Address - Country:US
Practice Address - Phone:626-629-6977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86099976133V00000X
NV40366-DI-0133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered