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General NPI Number Information
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NPI Number | 1760644140
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Entity Type | Organization
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Legal Business Name | SUNNY HAN MEDICAL CENTER INC
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 1661 HANOVER RD STE 201
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-1735
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Country | US
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Telephone | 626-589-3898
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Fax | 626-965-4625
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Provider Business Mailing Address
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Address Line | 1661 HANOVER RD #201
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748
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Country | US
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Telephone |
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Fax | 626-965-4625
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Authorized Official
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Title or Position | OWNER
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Name | LI HAN
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Credential |
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Telephone | 626-589-3898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | LAC 11061
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License Number State | CA
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