Provider Demographics
NPI:1962760231
Name:HAN, ALBERT (DC)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 SAN RAMON VALLEY BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1788
Mailing Address - Country:US
Mailing Address - Phone:925-838-8055
Mailing Address - Fax:
Practice Address - Street 1:2410 SAN RAMON VALLEY BLVD STE 115
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1788
Practice Address - Country:US
Practice Address - Phone:925-838-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31869111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor