Provider Demographics
NPI:1255539334
Name:AUM, SEOK JOO (LAC)
Entity type:Individual
Prefix:
First Name:SEOK
Middle Name:JOO
Last Name:AUM
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 NEWPORT BLVD STE D254
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-5013
Mailing Address - Country:US
Mailing Address - Phone:949-722-8658
Mailing Address - Fax:949-722-8941
Practice Address - Street 1:1835 NEWPORT BLVD STE D254
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5013
Practice Address - Country:US
Practice Address - Phone:949-722-8658
Practice Address - Fax:949-722-8941
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7849171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist