Provider Demographics
NPI:1619218559
Name:HAN, YUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:YUNG
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:YUNG
Other - Middle Name:
Other - Last Name:HAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:505 S VIRGIL AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1443
Mailing Address - Country:US
Mailing Address - Phone:213-805-5822
Mailing Address - Fax:213-805-5812
Practice Address - Street 1:505 S VIRGIL AVE STE 205
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1443
Practice Address - Country:US
Practice Address - Phone:213-805-5822
Practice Address - Fax:213-805-5812
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124276207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine