Basic Information
| Provider Information | |||||||||
| NPI: | 1205968104 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAN | ||||||||
| FirstName: | GENE | ||||||||
| MiddleName: | CHY YUAN | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1070 MARINA VILLAGE PKWY | ||||||||
| Address2: | |||||||||
| City: | ALAMEDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945011076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107470527 | ||||||||
| FaxNumber: | 5103377969 | ||||||||
| Practice Location | |||||||||
| Address1: | 1475 HUNTINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | SOUTH SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940805990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6502463829 | ||||||||
| FaxNumber: | 6502463838 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 678116 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.