Healthcare Provider Details

I. General information

NPI: 1881252724
Provider Name (Legal Business Name): JE-BIN SEOK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 RICHMOND STREET
LONDON ONTARIO
N6A 5C1
CA

IV. Provider business mailing address

1300 MARLBOROUGH COURT 131
OAKVILLE ONTARIO
L6H2S2
CA

V. Phone/Fax

Practice location:
  • Phone: 519-661-3459
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: