Provider Demographics
NPI:1467610626
Name:CHOI, GWANG CHOL (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:GWANG
Middle Name:CHOL
Last Name:CHOI
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 COLLEGE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4340
Mailing Address - Country:US
Mailing Address - Phone:323-264-7215
Mailing Address - Fax:
Practice Address - Street 1:2120 COLLEGE VIEW DR
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4340
Practice Address - Country:US
Practice Address - Phone:323-264-7215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 6463171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC 6463OtherCALIFORNIA ACUPUNCTURIST BOARD