Individual
DR. SAMUEL SEUNGKWON LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
169 MARTIN AVE, EPHRATA, PA 17522-1734
(717) 738-6618
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
L6998
TX
2085N0904X
Nuclear Radiology Physician
L6998
TX
2085P0229X
Pediatric Radiology Physician
L6998
TX
2085R0202X
Diagnostic Radiology Physician
L6998
TX
2085R0202X
Diagnostic Radiology Physician
Primary
MD483989
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165035001
—
TX
01
—
8G8484
MEDICARE PTAN
TX
01
—
L6998
TX PHYSICIANS PERMIT
TX
Enumeration date
05/15/2006
Last updated
02/12/2026
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