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General NPI Number Information
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NPI Number | 1962159848
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Entity Type | Individual
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Provider Name | EILEEN SEUNG MEE HAN DDS
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Gender | Female
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 1054 VINE ST
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City | LOS ANGELES
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State | CA
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Zip | 90038-2745
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Country | US
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Telephone | 323-603-0285
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Fax |
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Provider Business Mailing Address
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Address Line | 500 S VIRGIL AVE STE 503
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City | LOS ANGELES
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State | CA
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Zip | 90020-1451
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 40154
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License Number State | CA
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