Provider Demographics
NPI:1134917255
Name:PARK, MADISON SEONG-HE (DACCHM, LAC)
Entity type:Individual
Prefix:DR
First Name:MADISON
Middle Name:SEONG-HE
Last Name:PARK
Suffix:
Gender:
Credentials:DACCHM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7224 MIRAMONTE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4839
Mailing Address - Country:US
Mailing Address - Phone:949-275-3364
Mailing Address - Fax:
Practice Address - Street 1:7224 MIRAMONTE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4839
Practice Address - Country:US
Practice Address - Phone:949-275-3364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20345171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist