Provider Demographics
NPI:1346430717
Name:OH, GYEONG SEOK (LAC)
Entity Type:Individual
Prefix:
First Name:GYEONG SEOK
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21550 YORBA LINDA BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-3768
Mailing Address - Country:US
Mailing Address - Phone:714-693-7961
Mailing Address - Fax:714-693-7931
Practice Address - Street 1:21550 YORBA LINDA BLVD STE C
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-3768
Practice Address - Country:US
Practice Address - Phone:714-693-7961
Practice Address - Fax:714-693-7931
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7227171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist