Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | A38291 | CA |
NPI | 1043305394 |
---|---|
Provider Name | Dr. Seon Ho Whang |
First Address | Los Angeles, CA 90020-3047 |
Second Address | Los Angeles, CA 90020-3047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 19/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A382970 | (05) | CA |
28585 | (02) | CA |
A38291 | PROFESSIONAL LICENSE # (01) | CA |