Provider Demographics
NPI:1336687607
Name:HAN, STEVE I (L AC)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:I
Last Name:HAN
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4519 ADMIRALTY WAY STE 130
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5455
Mailing Address - Country:US
Mailing Address - Phone:424-322-0575
Mailing Address - Fax:310-221-8902
Practice Address - Street 1:4519 ADMIRALTY WAY STE 130
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5455
Practice Address - Country:US
Practice Address - Phone:424-322-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2023-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17202171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist