Healthcare Provider Details

I. General information

NPI: 1538979711
Provider Name (Legal Business Name): JAE HWAN CHOE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4041 FRANKLIN AVE APT 5
FULLERTON CA
92833-3482
US

IV. Provider business mailing address

4041 FRANKLIN AVE APT 5
FULLERTON CA
92833-3482
US

V. Phone/Fax

Practice location:
  • Phone: 213-352-6900
  • Fax:
Mailing address:
  • Phone: 213-352-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC19675
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: