Basic Information
Provider Information
NPI: 1184005373
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOI
FirstName: JASON
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 300 PASTEUR DR
Address2:  
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber: 6507234000
FaxNumber:  
Practice Location
Address1: 300 PASTEUR DR
Address2:  
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber: 6507234000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/12/2015
LastUpdateDate: 07/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X125067081ILN Allopathic & Osteopathic PhysiciansNeurological Surgery 
207T00000XA176072CAY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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