Healthcare Provider Details

I. General information

NPI: 1063241313
Provider Name (Legal Business Name): JIN MI CHOI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 LAUREL CANYON BLVD STE A
STUDIO CITY CA
91604-3711
US

IV. Provider business mailing address

3959 LAUREL CANYON BLVD STE A
STUDIO CITY CA
91604-3711
US

V. Phone/Fax

Practice location:
  • Phone: 818-261-5006
  • Fax:
Mailing address:
  • Phone: 818-261-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20092
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: