Provider Demographics
NPI:1871045849
Name:CHOI, WON SIK
Entity type:Individual
Prefix:MR
First Name:WON SIK
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14435 SHERMAN WAY
Mailing Address - Street 2:101
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2331
Mailing Address - Country:US
Mailing Address - Phone:562-900-3399
Mailing Address - Fax:
Practice Address - Street 1:14435 SHERMAN WAY
Practice Address - Street 2:101
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2331
Practice Address - Country:US
Practice Address - Phone:562-900-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16526171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist