Provider Demographics
NPI:1982166880
Name:CHOI, JUNG IN (LAC)
Entity Type:Individual
Prefix:
First Name:JUNG IN
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:CHOI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:11752 GARDEN GROVE BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-1461
Mailing Address - Country:US
Mailing Address - Phone:714-845-8329
Mailing Address - Fax:657-427-6118
Practice Address - Street 1:11752 GARDEN GROVE BLVD STE 218
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1461
Practice Address - Country:US
Practice Address - Phone:714-845-8329
Practice Address - Fax:657-427-6118
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18462171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist