Provider Demographics
NPI:1548823156
Name:BAHNG, SEOKJAE JOHN (MD)
Entity type:Individual
Prefix:MR
First Name:SEOKJAE
Middle Name:JOHN
Last Name:BAHNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:SEOK JAE
Other - Middle Name:
Other - Last Name:BANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5970 QUEBEC ST.
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:BRITISH COLUMBIA
Mailing Address - Zip Code:V5W 2P3
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ONE GUTHRIE SQUARE, GUTHRIE/ROBERT PACKER HOSPITAL
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840
Practice Address - Country:US
Practice Address - Phone:570-887-3381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program