Provider Demographics
NPI:1609926583
Name:CHOO, TAE CHEONG (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:TAE CHEONG
Middle Name:
Last Name:CHOO
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 1:3663 W 6TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3048
Mailing Address - Country:US
Mailing Address - Phone:213-381-1700
Mailing Address - Fax:213-381-1701
Practice Address - Street 1:3663 W 6TH ST STE 202
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3048
Practice Address - Country:US
Practice Address - Phone:213-381-1700
Practice Address - Fax:213-381-1701
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7256171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist