MEDICARE: SEONG M. YOO, DPM MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	111NX0100X	Occupational Health Chiropractor
2	207Q00000X	Family Medicine Physician
3	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1861507501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEONG M. YOO, DPM MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	2144 S HACIENDA BLVD
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-4242
Country	:	US
Telephone Number	:	626-968-5882
Fax Number	:	626-968-0020

Provider Business Practice Location Address
First Line	:	2144 S HACIENDA BLVD
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-4242
Country	:	US
Telephone Number	:	626-968-5882
Fax Number	:	626-968-0020

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SEONG M. YOO
Credential	:	D.P.M.
Telephone Number	:	626-968-5882

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	01/04/2008

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