Provider Demographics
NPI:1144650193
Name:HAN, SEUNG YEUB (NP, FNP-C, L AC)
Entity type:Individual
Prefix:
First Name:SEUNG YEUB
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:NP, FNP-C, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 W 6TH ST STE 400B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-5020
Mailing Address - Country:US
Mailing Address - Phone:213-800-2682
Mailing Address - Fax:
Practice Address - Street 1:3251 W 6TH ST STE 400B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-5020
Practice Address - Country:US
Practice Address - Phone:714-742-7314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2020-07-29
Deactivation Date:2017-12-19
Deactivation Code:
Reactivation Date:2019-09-05
Provider Licenses
StateLicense IDTaxonomies
CAAC 12521171100000X
CA95009923363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No171100000XOther Service ProvidersAcupuncturist