Provider Demographics
NPI:1134998974
Name:DEWEESE, KYUNG OK CHOI
Entity type:Individual
Prefix:DR
First Name:KYUNG OK
Middle Name:CHOI
Last Name:DEWEESE
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 1:401 S HOOVER ST APT 301
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1215
Mailing Address - Country:US
Mailing Address - Phone:323-447-0202
Mailing Address - Fax:
Practice Address - Street 1:401 S HOOVER ST APT 301
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1215
Practice Address - Country:US
Practice Address - Phone:323-447-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA19863171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist