Provider Demographics
NPI:1396136602
Name:DAVID HAN AND JASON GIM, A GENERAL PARTNERSHIP
Entity type:Organization
Organization Name:DAVID HAN AND JASON GIM, A GENERAL PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:661-254-1924
Mailing Address - Street 1:28212 KELLY JOHNSON PKWY STE 290
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5093
Mailing Address - Country:US
Mailing Address - Phone:661-254-1924
Mailing Address - Fax:
Practice Address - Street 1:28212 KELLY JOHNSON PKWY STE 290
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5093
Practice Address - Country:US
Practice Address - Phone:661-254-1924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty