Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E4519 | CA |
NPI | 1093823346 |
---|---|
Provider Name | Dr. Seong M. Yoo |
First Address | Santa Monica, CA 90401-2108 |
Second Address | Santa Monica, CA 90401-2108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U98600 | (02) | CA |