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NPI Code Detail

MEDICARE: KYOUNG WON HAN DDS

MEDICARE: KYOUNG WON HAN DDS
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
1122300000XDentist104272CA

General Provider Information

NPI Number : 1063063774
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYOUNG WON HAN DDS
Provider Business Mailing Address
First Line : 2950 INTERNATIONAL BLVD
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2228
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2950 INTERNATIONAL BLVD
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2228
Country : US
Telephone Number : 510-485-5925
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2019
Last Update Date : 04/16/2026

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Directions to “ KYOUNG WON HAN DDS” Practice Location

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