MEDICARE: QI HAN L.AC.

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	AC4270	CA

General Provider Information

NPI Number	:	1508980863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QI HAN L.AC.

Provider Business Mailing Address
First Line	:	2858 BREAKER CIR
Second Line	:
City	:	HAYWARD
State	:	CA
Zip	:	94545-1349
Country	:	US
Telephone Number	:	415-681-6598
Fax Number	:	415-566-0852

Provider Business Practice Location Address
First Line	:	3341 JUDAH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94122-1324
Country	:	US
Telephone Number	:	415-681-6598
Fax Number	:	415-566-0852

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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Directions to “ QI HAN L.AC.” Practice Location

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