Provider Demographics
NPI:1881405199
Name:HAN, NINA HYUNJUNG
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:HYUNJUNG
Last Name:HAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 WESTERLY PL STE 116
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2331
Mailing Address - Country:US
Mailing Address - Phone:714-402-8744
Mailing Address - Fax:
Practice Address - Street 1:4121 WESTERLY PL STE 116
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2331
Practice Address - Country:US
Practice Address - Phone:714-402-8744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8029171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist