Provider Demographics
NPI:1942795117
Name:CHOI, SARA (OD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 S GREENVILLE ST UNIT F
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6048
Mailing Address - Country:US
Mailing Address - Phone:949-241-4663
Mailing Address - Fax:
Practice Address - Street 1:1103 PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-6245
Practice Address - Country:US
Practice Address - Phone:562-666-9800
Practice Address - Fax:562-330-3900
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-906152W00000X
390200000X
CA33990TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program