Healthcare Provider Details

I. General information

NPI: 1871090449
Provider Name (Legal Business Name): HEUI SEUNG UHM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19200 JAMBOREE RD STE 2000
IRVINE CA
92612-2571
US

IV. Provider business mailing address

19200 JAMBOREE RD STE 2000
IRVINE CA
92612-2571
US

V. Phone/Fax

Practice location:
  • Phone: 949-898-6000
  • Fax: 949-898-6011
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA164173
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: