Provider Demographics
NPI:1427028927
Name:HAN, TONY S (MD)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:S
Last Name:HAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18380 BERNARDO TRAILS DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-1128
Mailing Address - Country:US
Mailing Address - Phone:858-705-2537
Mailing Address - Fax:619-532-7625
Practice Address - Street 1:34800 BOB WILSON DR STE 3-3
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-2161
Practice Address - Country:US
Practice Address - Phone:619-532-7621
Practice Address - Fax:619-532-7625
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHI10940207RP1001X
CAG133252207RS0012X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine