Provider Demographics
NPI:1154702165
Name:CHOE, JIN (LAC)
Entity type:Individual
Prefix:
First Name:JIN
Middle Name:
Last Name:CHOE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:3062 KALLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-4201
Mailing Address - Country:US
Mailing Address - Phone:415-246-7873
Mailing Address - Fax:
Practice Address - Street 1:4050 KATELLA AVE STE 213
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3486
Practice Address - Country:US
Practice Address - Phone:415-326-4554
Practice Address - Fax:562-249-1837
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16313171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist