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NPI Code Detail

MEDICARE: SEUNG YEON SEO

MEDICARE: SEUNG YEON SEO
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1154267193
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEUNG YEON SEO
Provider Business Mailing Address
First Line : 1798 N GAREY AVE
Second Line :
City : POMONA
State : CA
Zip : 91767-2918
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1798 N GAREY AVE
Second Line :
City : POMONA
State : CA
Zip : 91767-2918
Country : US
Telephone Number : 909-865-9500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2026
Last Update Date : 04/23/2026

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Directions to “ SEUNG YEON SEO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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