Healthcare Provider Details

I. General information

NPI: 1235793266
Provider Name (Legal Business Name): CHIHUN JIM HAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CHESTNUT ST FL 6
PHILADELPHIA PA
19107-4204
US

IV. Provider business mailing address

3600 FORBES AVE STE 140
PITTSBURGH PA
15213-3410
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-6760
  • Fax: 215-503-3736
Mailing address:
  • Phone: 412-647-6340
  • Fax: 412-647-5809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License NumberMT218569
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number25MA12598500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: