Provider Demographics
NPI:1518262161
Name:CHOI, HYUNSUK (DDS)
Entity Type:Individual
Prefix:
First Name:HYUNSUK
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-5906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24682 STEWART ST
Practice Address - Street 2:STE A
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2785
Practice Address - Country:US
Practice Address - Phone:661-328-0876
Practice Address - Fax:661-327-4733
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA612231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice