Provider Demographics
NPI:1194884395
Name:HAN, YOUNGHEE
Entity type:Individual
Prefix:
First Name:YOUNGHEE
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 FAIRWAY DR STE 102
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2847
Mailing Address - Country:US
Mailing Address - Phone:909-718-0244
Mailing Address - Fax:909-718-0224
Practice Address - Street 1:1169 FAIRWAY DR STE 102
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91789-2847
Practice Address - Country:US
Practice Address - Phone:909-718-0244
Practice Address - Fax:909-718-0224
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6417171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist