Provider Demographics
NPI:1831252105
Name:CHOE, YONG CHUN (DDS)
Entity type:Individual
Prefix:DR
First Name:YONG
Middle Name:CHUN
Last Name:CHOE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 W OLYMPIC BLVD
Mailing Address - Street 2:300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2880
Mailing Address - Country:US
Mailing Address - Phone:213-739-0150
Mailing Address - Fax:213-739-0250
Practice Address - Street 1:2675 W OLYMPIC BLVD
Practice Address - Street 2:300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2880
Practice Address - Country:US
Practice Address - Phone:213-739-0150
Practice Address - Fax:213-739-0250
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice