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General NPI Number Information
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NPI Number | 1952632549
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Entity Type | Organization
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Legal Business Name | YOUNG CHOI MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 3020 WILSHIRE BLVD 160A
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City | LOS ANGELES
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State | CA
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Zip | 90010-1120
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Country | US
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Telephone | 213-738-0059
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Fax | 213-738-0032
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Provider Business Mailing Address
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Address Line | 3020 WILSHIRE BLVD 160A
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City | LOS ANGELES
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State | CA
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Zip | 90010-1120
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Country | US
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Telephone | 213-738-0059
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Fax | 213-738-0032
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | YOUNG SOO CHOI
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Credential | MD
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Telephone | 213-738-0059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | C41054
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License Number State | CA
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