Provider Demographics
NPI:1780869321
Name:CHOI, YEESAN
Entity type:Individual
Prefix:MR
First Name:YEESAN
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 S DEL MAR AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-4150
Mailing Address - Country:US
Mailing Address - Phone:626-927-2007
Mailing Address - Fax:
Practice Address - Street 1:1835 S DEL MAR AVE STE 102
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-4150
Practice Address - Country:US
Practice Address - Phone:626-927-2007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4940171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist