Healthcare Provider Details

I. General information

NPI: 1780228874
Provider Name (Legal Business Name): YOUNG H CHOI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23441 S POINTE DR STE 325
LAGUNA HILLS CA
92653-1549
US

IV. Provider business mailing address

6575 VIA BARONA
CARLSBAD CA
92009-4518
US

V. Phone/Fax

Practice location:
  • Phone: 949-454-9016
  • Fax:
Mailing address:
  • Phone: 206-719-0547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number114813
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: