Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E4917 | CA |
NPI | 1043510431 |
---|---|
Provider Name | James Han |
First Address | Oceanside, CA 92054 |
Second Address | Oceanside, CA 92054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2010 |
Last Update Date | 14/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E4917 | LICENSE (01) | CA |