Provider Demographics
NPI:1427196864
Name:HAN, GUANGYU (MSOM)
Entity Type:Individual
Prefix:
First Name:GUANGYU
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 S OXFORD AVE
Mailing Address - Street 2:#310
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-4245
Mailing Address - Country:US
Mailing Address - Phone:213-386-8523
Mailing Address - Fax:
Practice Address - Street 1:2500 W 8TH ST
Practice Address - Street 2:#203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3860
Practice Address - Country:US
Practice Address - Phone:213-388-7889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11440171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist