Provider Demographics
NPI:1346579596
Name:SAMANTHA H. HAN M D A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:SAMANTHA H. HAN M D A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-846-8981
Mailing Address - Street 1:191 S BUENA VISTA ST
Mailing Address - Street 2:SUITE: 300
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4554
Mailing Address - Country:US
Mailing Address - Phone:818-846-8981
Mailing Address - Fax:818-846-8985
Practice Address - Street 1:191 S BUENA VISTA ST
Practice Address - Street 2:SUITE: 300
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4554
Practice Address - Country:US
Practice Address - Phone:818-846-8981
Practice Address - Fax:818-846-8985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty