Provider Demographics
NPI:1417050378
Name:CHOI, JAMES SONG (DC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:SONG
Last Name:CHOI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S. WINCHESTER BLVD
Mailing Address - Street 2:K234
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3904
Mailing Address - Country:US
Mailing Address - Phone:408-260-0222
Mailing Address - Fax:408-260-0297
Practice Address - Street 1:1101 S. WINCHESTER BLVD
Practice Address - Street 2:K234
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3904
Practice Address - Country:US
Practice Address - Phone:408-260-0222
Practice Address - Fax:408-260-0297
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor