Provider Demographics
NPI:1558457143
Name:LEE, HAN N (MD)
Entity Type:Individual
Prefix:DR
First Name:HAN
Middle Name:N
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:625 S FAIR OAKS AVE 200
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2651
Mailing Address - Country:US
Mailing Address - Phone:626-793-7790
Mailing Address - Fax:626-793-9018
Practice Address - Street 1:435 W ARDEN AVE
Practice Address - Street 2:#435
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4044
Practice Address - Country:US
Practice Address - Phone:818-246-4936
Practice Address - Fax:818-246-4937
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA80177207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00244332OtherRR MEDICARE
CA00A801770Medicaid
CAP00244332OtherRR MEDICARE
CAH47789Medicare UPIN