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General NPI Number Information
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NPI Number | 1174030522
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Entity Type | Individual
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Provider Name | JUNG HOON HOON CHOI DDS
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Gender | Male
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 1075 N WESTERN AVE STE 102
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City | LOS ANGELES
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State | CA
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Zip | 90029-2346
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Country | US
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Telephone | 323-466-4567
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Fax |
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Provider Business Mailing Address
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Address Line | 4395 KARI LN
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City | SANTA MARIA
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State | CA
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Zip | 93455
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Country | US
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Telephone | 805-300-5905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 102165
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License Number State | CA
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