Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | A85098 | CA |
NPI | 1114952850 |
---|---|
Provider Name | Caroline M. Han |
First Address | Laguna Niguel, CA 92677-2364 |
Second Address | Irvine, CA 92618-3716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 22/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H23414 | (02) | WA |