Provider Demographics
NPI:1942607700
Name:CHOI, EUN JU
Entity Type:Individual
Prefix:
First Name:EUN JU
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22879 HILTON HEAD DR UNIT 242
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4411
Mailing Address - Country:US
Mailing Address - Phone:213-505-7436
Mailing Address - Fax:
Practice Address - Street 1:22879 HILTON HEAD DR UNIT 242
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4411
Practice Address - Country:US
Practice Address - Phone:213-505-7436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16007171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist