Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | OT011370 | PA |
Y | 2081P2900X | Pain Medicine | 20A10790 | CA |
NPI | 1013073030 |
---|---|
Provider Name | Dr. James Han |
First Address | Pleasanton, CA 94588-2828 |
Second Address | Pleasanton, CA 94588-2828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 16/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FL576Z | MEDICARE ID (01) | CA |