Provider Demographics
NPI:1235795097
Name:HAN ACU&HERBS, INC
Entity Type:Organization
Organization Name:HAN ACU&HERBS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L,AC
Authorized Official - Prefix:
Authorized Official - First Name:HAI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-797-9020
Mailing Address - Street 1:32387 YUCAIPA BLVD
Mailing Address - Street 2:STE, F
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399
Mailing Address - Country:US
Mailing Address - Phone:909-797-9020
Mailing Address - Fax:909-363-0101
Practice Address - Street 1:32387 YUCAIPA BLVD
Practice Address - Street 2:STE, F
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399
Practice Address - Country:US
Practice Address - Phone:909-797-9020
Practice Address - Fax:909-363-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC14490Medicaid