Provider Demographics
NPI:1023670767
Name:SEO, SUENG NIM (RN)
Entity type:Individual
Prefix:MRS
First Name:SUENG NIM
Middle Name:
Last Name:SEO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 APIA DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5504
Mailing Address - Country:US
Mailing Address - Phone:714-585-4493
Mailing Address - Fax:
Practice Address - Street 1:5704 APIA DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5504
Practice Address - Country:US
Practice Address - Phone:714-585-4493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA536279163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency