Provider Demographics
NPI:1306338538
Name:CHOI, STEVEN SUNGEUN (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:SUNGEUN
Last Name:CHOI
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 LINCOLN CT
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-4611
Mailing Address - Country:US
Mailing Address - Phone:310-770-9584
Mailing Address - Fax:
Practice Address - Street 1:35 LINCOLN CT
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4611
Practice Address - Country:US
Practice Address - Phone:310-770-9584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC18055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC18055OtherCALIFORNIA ACUPUNCTURE BOARD