Provider Demographics
NPI:1942455852
Name:HAN, BOK SHIL (LAC)
Entity Type:Individual
Prefix:
First Name:BOK
Middle Name:SHIL
Last Name:HAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 WILSHIRE BLVD
Mailing Address - Street 2:206
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3408
Mailing Address - Country:US
Mailing Address - Phone:213-487-6608
Mailing Address - Fax:
Practice Address - Street 1:4041 WILSHIRE BLVD
Practice Address - Street 2:206
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3408
Practice Address - Country:US
Practice Address - Phone:213-487-6608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10279171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist