Provider Demographics
NPI:1831398999
Name:SHIM, SEONG UK (LAC)
Entity type:Individual
Prefix:
First Name:SEONG UK
Middle Name:
Last Name:SHIM
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:40680 CALIFORNIA OAKS RD
Mailing Address - Street 2:STE 2-D
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562
Mailing Address - Country:US
Mailing Address - Phone:951-696-2779
Mailing Address - Fax:951-696-2778
Practice Address - Street 1:40680 CALIFORNIA OAKS RD
Practice Address - Street 2:STE 2-D
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-696-2779
Practice Address - Fax:951-696-2778
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC 10222171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist