Provider Demographics
NPI:1093823346
Name:YOO, SEONG M (DPM)
Entity Type:Individual
Prefix:DR
First Name:SEONG
Middle Name:M
Last Name:YOO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23043 LYONS AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2719
Mailing Address - Country:US
Mailing Address - Phone:310-434-0044
Mailing Address - Fax:310-434-0099
Practice Address - Street 1:23043 LYONS AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2719
Practice Address - Country:US
Practice Address - Phone:310-434-0044
Practice Address - Fax:310-434-0099
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4519213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU98600Medicare UPIN
CADI337AMedicare PIN