MEDICARE: DR. JAMES HAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	20A10790	CA
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	20A10790	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FL576Z	OTHER	CA	MEDICARE ID

General Provider Information

NPI Number	:	1013073030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES HAN

Provider Business Mailing Address
First Line	:	1081 MARKET PL STE 600
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-4750
Country	:	US
Telephone Number	:	925-401-7113
Fax Number	:	855-422-2762

Provider Business Practice Location Address
First Line	:	1081 MARKET PL STE 600
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-4750
Country	:	US
Telephone Number	:	925-401-7113
Fax Number	:	855-422-2762

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	12/23/2024

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Directions to “ DR. JAMES HAN ” Practice Location

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