Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E5043 | CA |
NPI | 1083954671 |
---|---|
Provider Name | Kyoung Min Han |
First Address | Poway, CA 92064-2032 |
Second Address | Poway, CA 92064-2032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2013 |
Last Update Date | 23/07/2021 |