Provider Demographics
NPI:1720747538
Name:CHOE, DANIEL (LAC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CHOE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5770 MELROSE AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90038-3873
Mailing Address - Country:US
Mailing Address - Phone:213-675-0111
Mailing Address - Fax:323-469-0747
Practice Address - Street 1:5770 MELROSE AVE STE 207
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-3873
Practice Address - Country:US
Practice Address - Phone:213-675-0111
Practice Address - Fax:323-469-0747
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty