MEDICARE: DR. IN BOCK HAN PHD

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	171100000X	Acupuncturist	AC5802	CA

General Provider Information

NPI Number	:	1154538411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IN BOCK HAN PHD

Provider Business Mailing Address
First Line	:	235 N WESTERN AVE STE A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4107
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 N WESTERN AVE STE A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4107
Country	:	US
Telephone Number	:	323-463-5454
Fax Number	:

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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