Provider Demographics
NPI:1861882813
Name:JOON HO CHOE DDS, INC.
Entity type:Organization
Organization Name:JOON HO CHOE DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GYOUNG-HWA
Authorized Official - Middle Name:
Authorized Official - Last Name:JU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:2136-312-5555
Mailing Address - Street 1:333 S ALAMEDA ST
Mailing Address - Street 2:SUITE 213
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1740
Mailing Address - Country:US
Mailing Address - Phone:213-631-2555
Mailing Address - Fax:213-631-2556
Practice Address - Street 1:333 S ALAMEDA ST
Practice Address - Street 2:SUITE 213
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1740
Practice Address - Country:US
Practice Address - Phone:213-631-2555
Practice Address - Fax:213-631-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QD0000X
CA261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental