Provider Demographics
NPI:1902965718
Name:CHOE, UNPOK JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:UNPOK
Middle Name:JOHN
Last Name:CHOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:CHOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:78-6831 ALI'I DRIVE
Mailing Address - Street 2:SUITE 328
Mailing Address - City:KAILUA-KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740
Mailing Address - Country:US
Mailing Address - Phone:808-747-8321
Mailing Address - Fax:808-331-8682
Practice Address - Street 1:78-6831 ALI'I DRIVE
Practice Address - Street 2:SUITE 328
Practice Address - City:KAILUA-KONA
Practice Address - State:HI
Practice Address - Zip Code:96740
Practice Address - Country:US
Practice Address - Phone:808-747-8321
Practice Address - Fax:808-334-0930
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41959207RG0300X
HIMD6632207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO78157773Medicaid
HIH103297Medicaid
HIH103297Medicaid
H103297Medicare PIN
CO509078Medicare ID - Type Unspecified