MEDICARE: DR. YONG CHUN CHOE DDS

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	52593	CA

General Provider Information

NPI Number	:	1831252105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YONG CHUN CHOE DDS

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	11/02/2009

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