Healthcare Provider Details

I. General information

NPI: 1245155969
Provider Name (Legal Business Name): HA RANG SEO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 S OCCIDENTAL BLVD APT 104
LOS ANGELES CA
90057-1281
US

IV. Provider business mailing address

235 S OCCIDENTAL BLVD APT 104
LOS ANGELES CA
90057-1281
US

V. Phone/Fax

Practice location:
  • Phone: 213-926-6801
  • Fax:
Mailing address:
  • Phone: 213-926-6801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number308856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: