Provider Demographics
NPI:1336782531
Name:YI, SEUNG HAE
Entity Type:Individual
Prefix:
First Name:SEUNG HAE
Middle Name:
Last Name:YI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 PENDIO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1756
Mailing Address - Country:US
Mailing Address - Phone:949-664-3100
Mailing Address - Fax:
Practice Address - Street 1:1727 PENDIO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-1756
Practice Address - Country:US
Practice Address - Phone:949-664-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist