Healthcare Provider Details

I. General information

NPI: 1073451290
Provider Name (Legal Business Name): HAN AND ELK GROVE OPTOMETRIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8829 SHELDON RD STE 150
ELK GROVE CA
95624-5045
US

IV. Provider business mailing address

374 SEATON DR
FOLSOM CA
95630-7947
US

V. Phone/Fax

Practice location:
  • Phone: 916-549-6728
  • Fax:
Mailing address:
  • Phone: 916-549-6728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JING HAN
Title or Position: CEO
Credential: OD
Phone: 916-549-6728