Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT199395 | PA |
N | 111NI0900X | Internist | MT199395 | PA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 156570 | CA |
NPI | 1043503675 |
---|---|
Provider Name | Moonjoo Han |
First Address | Sacramento, CA 95817-2208 |
Second Address | Sacramento, CA 95817-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2011 |
Last Update Date | 12/10/2018 |