MEDICARE: GENE S HAN, M.D., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	G66800	CA
2	207W00000X	Ophthalmology Physician	G61197	CA

General Provider Information

NPI Number	:	1093800112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENE S HAN, M.D., INC.

Provider Business Mailing Address
First Line	:	3224 W OLYMPIC BLVD
Second Line	:	#203
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2317
Country	:	US
Telephone Number	:	323-731-2020
Fax Number	:	323-731-2134

Provider Business Practice Location Address
First Line	:	3224 W OLYMPIC BLVD
Second Line	:	#203
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2317
Country	:	US
Telephone Number	:	323-731-2020
Fax Number	:	323-731-2134

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GENE S HAN
Credential	:	M.D.
Telephone Number	:	323-731-2020

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	03/24/2020

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