MEDICARE: JEONG SIK CHOI L.AC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC14188	CA

General Provider Information

NPI Number	:	1083904650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEONG SIK CHOI L.AC

Provider Business Mailing Address
First Line	:	13735 VENTURA BLVD
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-3023
Country	:	US
Telephone Number	:	818-789-2468
Fax Number	:	818-981-2766

Provider Business Practice Location Address
First Line	:	13735 VENTURA BLVD
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-3023
Country	:	US
Telephone Number	:	818-789-2468
Fax Number	:	818-981-2766

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2011
Last Update Date	:	04/15/2011

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Directions to “ JEONG SIK CHOI L.AC” Practice Location

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