Provider Demographics
NPI:1750657631
Name:HAN, PILL
Entity Type:Individual
Prefix:
First Name:PILL
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IRIS
Other - Middle Name:
Other - Last Name:HAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7235 ORANGETHROPE AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1382
Mailing Address - Country:US
Mailing Address - Phone:714-785-7542
Mailing Address - Fax:714-562-9329
Practice Address - Street 1:7235 ORANGETHORPE AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3311
Practice Address - Country:US
Practice Address - Phone:714-785-7542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14493171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist