Provider Demographics
NPI:1598370249
Name:HAN, JIHYE (RPH)
Entity Type:Individual
Prefix:
First Name:JIHYE
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3855 ELIJAH CT UNIT 737
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6010
Mailing Address - Country:US
Mailing Address - Phone:714-788-9748
Mailing Address - Fax:
Practice Address - Street 1:2255 S EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6318
Practice Address - Country:US
Practice Address - Phone:760-828-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist