Provider Demographics
NPI:1225357965
Name:CHOI, MIN (LAC)
Entity Type:Individual
Prefix:
First Name:MIN
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2442
Mailing Address - Country:US
Mailing Address - Phone:213-621-2652
Mailing Address - Fax:213-621-2654
Practice Address - Street 1:706 W 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2442
Practice Address - Country:US
Practice Address - Phone:213-621-2652
Practice Address - Fax:213-621-2654
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13691171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist