Healthcare Provider Details

I. General information

NPI: 1780158097
Provider Name (Legal Business Name): JOY MYUNGYEON CHOI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2019
Last Update Date: 01/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W SOUTHGATE AVE
FULLERTON CA
92833-4019
US

IV. Provider business mailing address

1301 W SOUTHGATE AVE
FULLERTON CA
92833-4019
US

V. Phone/Fax

Practice location:
  • Phone: 714-392-3348
  • Fax:
Mailing address:
  • Phone: 714-392-3348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC18279
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: