Provider Demographics
NPI:1972764330
Name:HAN, SANG HUN (LAC)
Entity Type:Individual
Prefix:DR
First Name:SANG HUN
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 W FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3302
Mailing Address - Country:US
Mailing Address - Phone:909-621-5163
Mailing Address - Fax:909-624-1936
Practice Address - Street 1:843 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3302
Practice Address - Country:US
Practice Address - Phone:909-621-5163
Practice Address - Fax:909-624-1936
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5109171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist