Provider Demographics
NPI:1558698738
Name:CHOI, CHULHEON
Entity Type:Individual
Prefix:
First Name:CHULHEON
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 N PERRIS BLVD STE E6
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-2517
Mailing Address - Country:US
Mailing Address - Phone:951-940-7900
Mailing Address - Fax:951-940-7900
Practice Address - Street 1:2055 N PERRIS BLVD STE E6
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-2517
Practice Address - Country:US
Practice Address - Phone:951-940-7900
Practice Address - Fax:951-940-7900
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13309171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist