Provider Demographics
NPI:1043305394
Name:WHANG, SEON HO
Entity Type:Individual
Prefix:DR
First Name:SEON
Middle Name:HO
Last Name:WHANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3663 W 6TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3047
Mailing Address - Country:US
Mailing Address - Phone:213-381-7272
Mailing Address - Fax:
Practice Address - Street 1:3663 W 6TH ST STE 106
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3047
Practice Address - Country:US
Practice Address - Phone:213-381-7272
Practice Address - Fax:213-529-4117
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38291207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A382970Medicaid
CAA38291OtherPROFESSIONAL LICENSE #
CA28585Medicare UPIN
CA00A382970Medicaid