| Doctor Name: | MR. TRAVIS SEUNG OH |
| NPI Number: | 1083951263 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 22636 |
| Business Practice Address: | 11841 South St Cerritos, CA - 907036825 |
| Business Phone Number: | 5628098082 |
| Business Fax Number: | |
| Mailing Address: | 1275 S Cabernet Cir, ANAHEIM |
| State: | CA |
| Postal Code: | 928044741 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/08/2013 |
| NPI Last Update Date: | 02/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 22636 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |