Healthcare Provider Details

I. General information

NPI: 1316409204
Provider Name (Legal Business Name): CHRISTINA HAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

333 CITY BLVD W STE 2150
ORANGE CA
92868-5920
US

V. Phone/Fax

Practice location:
  • Phone: 714-880-7812
  • Fax:
Mailing address:
  • Phone: 714-456-6661
  • Fax: 714-456-7702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number179587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: