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General NPI Number Information
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NPI Number | 1255879235
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Entity Type | Individual
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Provider Name | SHANG HAN HA8163
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Gender | Male
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 19367 VICTORY BLVD 14
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City | TARZANA
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State | CA
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Zip | 91335-6302
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Country | US
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Telephone | 818-343-8116
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Fax |
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Provider Business Mailing Address
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Address Line | 19637 VICTORY BLVD. 14
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City | RESEDA
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State | CA
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Zip | 91335-6302
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Country | US
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Telephone | 818-343-8116
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA8163
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License Number State | CA
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