Provider Demographics
NPI:1013073030
Name:HAN, JAMES
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 STONERIDGE MALL RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-2828
Mailing Address - Country:US
Mailing Address - Phone:925-401-7113
Mailing Address - Fax:855-422-2762
Practice Address - Street 1:5720 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 250
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2828
Practice Address - Country:US
Practice Address - Phone:925-401-7113
Practice Address - Fax:855-422-2762
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT011370208100000X
CA20A107902081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFL576ZOtherMEDICARE ID