Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jae Woo Seo

Individual provider Physician Assistant · NPI 1265070023

Jae Woo Seo is a Physician Assistant in Los Angeles, California. Qualified in 2019, 7 years ago. Practices with Shine Mmg Inc, a 25-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
7
In the registry since
2019
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Practice location Address checks out

384 W 15th St
Los Angeles, CA 90015
Phone: (213) 742-5555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1265070023
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 11, 2019
Last updated in NPPESDecember 14, 2021
Certification dateDecember 9, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Shine Mmg Inc — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Los Angeles