Provider Demographics
NPI:1164632295
Name:CHOI, KENNETH Y (AC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:Y
Last Name:CHOI
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 W 6TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-5107
Mailing Address - Country:US
Mailing Address - Phone:213-365-0781
Mailing Address - Fax:818-366-7078
Practice Address - Street 1:3750 W 6TH ST STE 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-5107
Practice Address - Country:US
Practice Address - Phone:213-365-0781
Practice Address - Fax:818-366-7078
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3774171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist