Provider Demographics
NPI:1225106198
Name:HAN, YUSHAN
Entity Type:Individual
Prefix:
First Name:YUSHAN
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10050 GARVEY AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-2088
Mailing Address - Country:US
Mailing Address - Phone:626-582-8586
Mailing Address - Fax:626-582-8586
Practice Address - Street 1:10050 GARVEY AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-2088
Practice Address - Country:US
Practice Address - Phone:626-582-8586
Practice Address - Fax:626-582-8586
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8132171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist