Provider Demographics
NPI:1942367180
Name:CHOE, CHONG SUNG (L AC)
Entity Type:Individual
Prefix:MR
First Name:CHONG
Middle Name:SUNG
Last Name:CHOE
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:CHONGSUNG
Other - Last Name:CHOE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:L AC
Mailing Address - Street 1:1818 S WESTERN AVE
Mailing Address - Street 2:#302
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-5807
Mailing Address - Country:US
Mailing Address - Phone:323-737-3000
Mailing Address - Fax:
Practice Address - Street 1:1818 S WESTERN AVE
Practice Address - Street 2:#302
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5807
Practice Address - Country:US
Practice Address - Phone:323-737-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4061171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist