MEDICARE: MR. CHONG SUNG 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	AC4061	CA

General Provider Information

NPI Number	:	1942367180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHONG SUNG CHOE L. AC

Provider Business Mailing Address
First Line	:	1818 S WESTERN AVE
Second Line	:	#302
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-5807
Country	:	US
Telephone Number	:	323-737-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 S WESTERN AVE
Second Line	:	#302
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-5807
Country	:	US
Telephone Number	:	323-737-3000
Fax Number	:

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	08/08/2008

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