Provider Demographics
NPI:1265910335
Name:YOON, SEON MI (L AC)
Entity type:Individual
Prefix:
First Name:SEON MI
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 SANTA MONICA BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-2783
Mailing Address - Country:US
Mailing Address - Phone:424-317-0014
Mailing Address - Fax:424-317-0917
Practice Address - Street 1:11901 SANTA MONICA BLVD STE 209
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-2783
Practice Address - Country:US
Practice Address - Phone:424-317-0014
Practice Address - Fax:424-317-0917
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18206171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist