Provider Demographics
NPI:1992092357
Name:HAN, JUNG HEE (DO)
Entity type:Individual
Prefix:
First Name:JUNG
Middle Name:HEE
Last Name:HAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10418 VALLEY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-3600
Mailing Address - Country:US
Mailing Address - Phone:626-258-1600
Mailing Address - Fax:626-258-1609
Practice Address - Street 1:10418 VALLEY BLVD STE A
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3600
Practice Address - Country:US
Practice Address - Phone:626-258-1600
Practice Address - Fax:626-258-1609
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12460207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine