Provider Demographics
NPI:1972927028
Name:CHOI, YOO JIN
Entity Type:Individual
Prefix:
First Name:YOO JIN
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 1:1217 MENDEZ DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-5621
Mailing Address - Country:US
Mailing Address - Phone:323-559-8900
Mailing Address - Fax:
Practice Address - Street 1:1217 MENDEZ DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-5621
Practice Address - Country:US
Practice Address - Phone:323-559-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 6752171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist