Healthcare Provider Details

I. General information

NPI: 1720435092
Provider Name (Legal Business Name): ERIC HAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13950 MILTON AVE STE 100
WESTMINSTER CA
92683-2939
US

IV. Provider business mailing address

17093 WESTPORT DR
HUNTINGTON BEACH CA
92649-4246
US

V. Phone/Fax

Practice location:
  • Phone: 714-702-3000
  • Fax:
Mailing address:
  • Phone: 203-809-1671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA196937
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: