Provider Demographics
NPI:1770980500
Name:HAN, JOHN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 504123
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92150-4123
Mailing Address - Country:US
Mailing Address - Phone:858-774-8860
Mailing Address - Fax:619-436-5572
Practice Address - Street 1:725 CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3536
Practice Address - Country:US
Practice Address - Phone:760-871-6868
Practice Address - Fax:760-872-6869
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA648471835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist