Provider Demographics
NPI:1578789269
Name:SEOK, PUCHUN (PHD,LAC)
Entity Type:Individual
Prefix:
First Name:PUCHUN
Middle Name:
Last Name:SEOK
Suffix:
Gender:M
Credentials:PHD,LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 S GLENDORA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-3418
Mailing Address - Country:US
Mailing Address - Phone:626-335-1918
Mailing Address - Fax:310-906-2186
Practice Address - Street 1:242 S GLENDORA AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-3418
Practice Address - Country:US
Practice Address - Phone:626-335-1918
Practice Address - Fax:310-906-2186
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11582171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist