MEDICARE: MR. YOON S CHOE L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC6555	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AC6555	OTHER	CA	LICENSED ACUPUNCTURIST

General Provider Information

NPI Number	:	1285701607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. YOON S CHOE L.AC.

Provider Business Mailing Address
First Line	:	2140 GRAND AVE
Second Line	:	SUITE 205
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-6800
Country	:	US
Telephone Number	:	909-627-0727
Fax Number	:	909-628-2650

Provider Business Practice Location Address
First Line	:	2140 GRAND AVE
Second Line	:	SUITE 205
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-6800
Country	:	US
Telephone Number	:	909-627-0727
Fax Number	:	909-628-2650

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	07/08/2007

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