Provider Demographics
NPI:1235280454
Name:KO, SEUNG HEE (LAC)
Entity Type:Individual
Prefix:MS
First Name:SEUNG
Middle Name:HEE
Last Name:KO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29231 GARNET CANYON DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91390-5769
Mailing Address - Country:US
Mailing Address - Phone:661-257-1233
Mailing Address - Fax:
Practice Address - Street 1:29231 GARNET CANYON DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91390-5769
Practice Address - Country:US
Practice Address - Phone:661-257-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 4938171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist