Provider Demographics
NPI:1952632549
Name:YOUNG CHOI MEDICAL CORPORATION
Entity Type:Organization
Organization Name:YOUNG CHOI MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:SOO
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-738-0059
Mailing Address - Street 1:3020 WILSHIRE BLVD
Mailing Address - Street 2:160A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1120
Mailing Address - Country:US
Mailing Address - Phone:213-738-0059
Mailing Address - Fax:213-738-0032
Practice Address - Street 1:3020 WILSHIRE BLVD
Practice Address - Street 2:160A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1120
Practice Address - Country:US
Practice Address - Phone:213-738-0059
Practice Address - Fax:213-738-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC41054208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty