Provider Demographics
NPI:1982929014
Name:AHN, SEUNGHOON
Entity Type:Individual
Prefix:
First Name:SEUNGHOON
Middle Name:
Last Name:AHN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 S MARIPOSA AVE
Mailing Address - Street 2:APT. 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-2051
Mailing Address - Country:US
Mailing Address - Phone:213-568-5465
Mailing Address - Fax:213-386-4560
Practice Address - Street 1:456 S SERRANO AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3670
Practice Address - Country:US
Practice Address - Phone:213-568-5465
Practice Address - Fax:213-386-4560
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12631171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist