Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | G78245 | CA |
NPI | 1023043189 |
---|---|
Provider Name | Mr. Clan Hyoku Hahn |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90020-1446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 11/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G72449 | (02) |