Provider Demographics
NPI:1427547223
Name:CHOE, DAEIN
Entity Type:Individual
Prefix:
First Name:DAEIN
Middle Name:
Last Name:CHOE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:CHOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11100 4TH ST APT D301
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5991
Mailing Address - Country:US
Mailing Address - Phone:862-219-8315
Mailing Address - Fax:
Practice Address - Street 1:11100 4TH ST APT D301
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5991
Practice Address - Country:US
Practice Address - Phone:862-219-8315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician