Provider Demographics
NPI:1770763948
Name:HAN, HEE SUNG (L AC)
Entity type:Individual
Prefix:
First Name:HEE SUNG
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 W AVENUE J STE 101
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2850
Mailing Address - Country:US
Mailing Address - Phone:661-942-3346
Mailing Address - Fax:661-942-0886
Practice Address - Street 1:1629 W AVENUE J STE 101
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2850
Practice Address - Country:US
Practice Address - Phone:661-942-3346
Practice Address - Fax:661-942-0886
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12140171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist