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General NPI Number Information
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NPI Number | 1043749401
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Entity Type | Individual
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Provider Name | SANG-KYOU HAN LAC, DIPL. OM, PHD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 756 GRAND AVE
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City | CARLSBAD
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State | CA
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Zip | 92008-2330
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Country | US
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Telephone | 760-421-1321
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Fax | 760-683-6903
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Provider Business Mailing Address
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Address Line | 5763 GABLEWOOD WAY
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City | SAN DIEGO
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State | CA
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Zip | 92130-4905
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Country | US
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Telephone | 760-421-1321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC17562
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License Number State | CA
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