Provider Demographics
NPI:1144236001
Name:CHOI, AE SOOK (FIT001CA)
Entity Type:Individual
Prefix:MS
First Name:AE SOOK
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:FIT001CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12235 CENTRALIA ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90715-1646
Mailing Address - Country:US
Mailing Address - Phone:562-402-7300
Mailing Address - Fax:562-402-7308
Practice Address - Street 1:12235 CENTRALIA ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90715-1646
Practice Address - Country:US
Practice Address - Phone:562-402-7300
Practice Address - Fax:562-402-7308
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FIT001CAOtherFAR INFRARED THERAPIST