Provider Demographics
NPI:1841264272
Name:HAN, MICHAEL SANG-YOON (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SANG-YOON
Last Name:HAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15642 SAND CANYON AVE UNIT 54123
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92619-5440
Mailing Address - Country:US
Mailing Address - Phone:949-484-8505
Mailing Address - Fax:
Practice Address - Street 1:15642 SAND CANYON AVE UNIT 54123
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92619-5440
Practice Address - Country:US
Practice Address - Phone:949-484-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11388207L00000X
CAA54113207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506092Medicaid
CA00A541130Medicaid
G82080Medicare UPIN
CAXPY203475Medicare ID - Type UnspecifiedMEDICAL
NV100881Medicare ID - Type Unspecified
NV100506092Medicaid