MEDICARE: DR SEO EYECARE OPTOMETRY INC

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
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1528853314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR SEO EYECARE OPTOMETRY INC

Provider Business Mailing Address
First Line	:	750 S OXFORD AVE APT 410
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-4628
Country	:	US
Telephone Number	:	704-962-5277
Fax Number	:

Provider Business Practice Location Address
First Line	:	3525 W 8TH ST STE 107
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-5030
Country	:	US
Telephone Number	:	704-962-5277
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	JIN SEO
Credential	:	O.D
Telephone Number	:	704-962-5277

Provider Enumeration Date	:	04/11/2025
Last Update Date	:	04/22/2025

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