Provider Demographics
NPI:1265613418
Name:CHOI, HYUNG SUP JEFF (PHD)
Entity type:Individual
Prefix:
First Name:HYUNG SUP
Middle Name:JEFF
Last Name:CHOI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27462 CALLE ARROYO
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-6762
Mailing Address - Country:US
Mailing Address - Phone:949-248-9899
Mailing Address - Fax:
Practice Address - Street 1:27462 CALLE ARROYO
Practice Address - Street 2:SUITE A
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-6762
Practice Address - Country:US
Practice Address - Phone:949-248-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11987171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist