Provider Demographics
NPI:1063792448
Name:CHOI, HYUN KYU
Entity type:Individual
Prefix:
First Name:HYUN KYU
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 1:3923 OLD LEE HWY STE 61C
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2428
Mailing Address - Country:US
Mailing Address - Phone:703-865-7582
Mailing Address - Fax:703-865-8508
Practice Address - Street 1:3923 OLD LEE HWY STE 61C
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2428
Practice Address - Country:US
Practice Address - Phone:703-865-7582
Practice Address - Fax:703-865-8508
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000567171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist