1952584211 NPI number — DR. HAN TAE CHOE OMD (ACUPUNCTURIST)

Table of content: (NPI 1760130207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952584211 NPI number — DR. HAN TAE CHOE OMD (ACUPUNCTURIST)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOE
Provider First Name:
HAN TAE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OMD (ACUPUNCTURIST)
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952584211
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19745 COLIMA RD
Provider Second Line Business Mailing Address:
SUITE 12 ( DR MIDAS MEDICAL GROUP )
Provider Business Mailing Address City Name:
ROWLAND HEIGHTS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91748-3219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-595-5550
Provider Business Mailing Address Fax Number:
626-310-0520

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7488 LIME AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FONTANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92336-3173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-825-6846
Provider Business Practice Location Address Fax Number:
909-356-5792
Provider Enumeration Date:
12/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC11000 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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