Provider Demographics
NPI:1982270252
Name:CHOE, JAMES CHONGWON
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHONGWON
Last Name:CHOE
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 1:200 S 13TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-2262
Mailing Address - Country:US
Mailing Address - Phone:805-728-1003
Mailing Address - Fax:
Practice Address - Street 1:200 S 13TH ST STE 110
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2262
Practice Address - Country:US
Practice Address - Phone:805-728-1003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17936171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist