MEDICARE: YONG CHUN CHOE DDS INC

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	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	B5259301	OTHER	CA	ACCESS DENTAL

General Provider Information

NPI Number	:	1467572529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YONG CHUN CHOE DDS INC

Provider Business Mailing Address
First Line	:	2675 W OLYMPIC BLVD
Second Line	:	300
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2880
Country	:	US
Telephone Number	:	213-739-0150
Fax Number	:	213-739-0250

Provider Business Practice Location Address
First Line	:	2675 W OLYMPIC BLVD
Second Line	:	300
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2880
Country	:	US
Telephone Number	:	213-739-0150
Fax Number	:	213-739-0250

Authorized Official
Title or Position	:	OWNER
Name	:	DR. YONG CHUN CHOE
Credential	:	DDS
Telephone Number	:	213-739-0150

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	02/05/2013

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Directions to “YONG CHUN CHOE DDS INC ” Practice Location

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