Provider Demographics
NPI:1326107400
Name:CHOI, YOUNG C (LAC)
Entity Type:Individual
Prefix:MR
First Name:YOUNG
Middle Name:C
Last Name:CHOI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:13011 NEWPORT AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3517
Mailing Address - Country:US
Mailing Address - Phone:714-730-7008
Mailing Address - Fax:714-730-7031
Practice Address - Street 1:13011 NEWPORT AVE STE 201
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3517
Practice Address - Country:US
Practice Address - Phone:714-730-7008
Practice Address - Fax:714-730-7031
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC10968171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist