Healthcare Provider Details

I. General information

NPI: 1235395997
Provider Name (Legal Business Name): JASON BEN-JUAN HAN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 VISTA AVE STE 103
PASADENA CA
91107-3699
US

IV. Provider business mailing address

145 VISTA AVE STE 103
PASADENA CA
91107-3699
US

V. Phone/Fax

Practice location:
  • Phone: 626-365-1380
  • Fax:
Mailing address:
  • Phone: 626-365-1380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT36996
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: