Provider Demographics
NPI:1114615622
Name:HAN, MINSEOK (RPH/PHARMD)
Entity type:Individual
Prefix:DR
First Name:MINSEOK
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:RPH/PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 S HIGHLAND AVE APT M
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-3382
Mailing Address - Country:US
Mailing Address - Phone:443-651-9611
Mailing Address - Fax:
Practice Address - Street 1:1401 S BROOKHURST RD STE 101
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-4492
Practice Address - Country:US
Practice Address - Phone:443-651-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist