Provider Demographics
NPI:1093838906
Name:HAN, MAN K (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MR
First Name:MAN
Middle Name:K
Last Name:HAN
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9656 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1516
Mailing Address - Country:US
Mailing Address - Phone:714-537-6360
Mailing Address - Fax:714-537-6360
Practice Address - Street 1:9656 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1516
Practice Address - Country:US
Practice Address - Phone:714-537-6360
Practice Address - Fax:714-537-6360
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11099171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC11099OtherACUPUNCTURE