Provider Demographics
NPI:1932591575
Name:CHOI, WON JUNG (LAC)
Entity Type:Individual
Prefix:
First Name:WON JUNG
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 N SERRANO AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-2712
Mailing Address - Country:US
Mailing Address - Phone:424-205-7271
Mailing Address - Fax:
Practice Address - Street 1:903 CRENSHAW BLVD
Practice Address - Street 2:304
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-1964
Practice Address - Country:US
Practice Address - Phone:213-200-8083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13283171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist