Provider Demographics
NPI:1396040143
Name:CHOI, JOONYONG (LAC)
Entity Type:Individual
Prefix:
First Name:JOONYONG
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 1:1210 S EUCLID ST
Mailing Address - Street 2:STE A
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-7306
Mailing Address - Country:US
Mailing Address - Phone:213-598-3047
Mailing Address - Fax:
Practice Address - Street 1:1210 S EUCLID ST
Practice Address - Street 2:STE A
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-7306
Practice Address - Country:US
Practice Address - Phone:213-598-3047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13930171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist