Provider Demographics
NPI:1720237357
Name:CHOI, BENEDICT YOUNG IL (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:BENEDICT
Middle Name:YOUNG IL
Last Name:CHOI
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:DR
Other - First Name:BEN
Other - Middle Name:
Other - Last Name:CHOI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC, LAC
Mailing Address - Street 1:3500 BARRANCA PKWY STE 280
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8233
Mailing Address - Country:US
Mailing Address - Phone:949-743-5470
Mailing Address - Fax:949-743-5471
Practice Address - Street 1:3500 BARRANCA PKWY STE 280
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8233
Practice Address - Country:US
Practice Address - Phone:949-743-5470
Practice Address - Fax:949-743-5471
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31016111N00000X
CA12429171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist