1871174367 NPI number — SEUNGWOO CHAI MD

Table of content: SEUNGWOO CHAI MD (NPI 1871174367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871174367 NPI number — SEUNGWOO CHAI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAI
Provider First Name:
SEUNGWOO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871174367
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
TOWER PALACE A-1306, 30 EONJU-RO 30-GIL, GANGNAM-GU
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEOUL
Provider Business Mailing Address State Name:
KOREA
Provider Business Mailing Address Postal Code:
06293
Provider Business Mailing Address Country Code:
KR
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1475 W 49TH PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33012-3113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-284-7774
Provider Business Practice Location Address Fax Number:
305-284-7787
Provider Enumeration Date:
04/16/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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