Individual provider Active NPI

Yong Gyu Han, LAC

  • Acupuncturist
  • Menlo Park, CA
National Provider Identifier
1093472508
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC19309 Issued in CA
Practice address
1220 University Dr # 202B
Menlo Park, CA 94025-4262
Phone
(408) 314-5472
NPI assigned
Nov 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC19309 CA Primary

Addresses

Primary practice location

1220 University Dr # 202B
Menlo Park, CA 94025-4262

Mailing address

300 Baltic Cir Unit 322
Redwood City, CA 94065-2249
Phone (669) 529-7767

Other names 1

  • Matthew Han Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC19309CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Acubalance Acupuncture Corp. Acupuncturist CurrentSince Dec 21, 2021 Accepting new patients
Medi Points Acupuncture Acupuncturist PastSince Nov 21, 2021 Accepting new patients

Locations

1220 University Dr
Ste 202B
Menlo Park, CA 94025
Phone (650) 400-8946

1220 University Dr
#202B
Menlo Park, CA 94025
Phone (408) 314-5472

182 S Murphy Ave
Sunnyvale, CA 94086
Phone (408) 329-9604

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1093472508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BALTIC CIR UNIT 322",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940652249",
            "telephone_number": "669-529-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 UNIVERSITY DR # 202B",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254262",
            "telephone_number": "408-314-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "YONG GYU",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-18",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC19309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTHEW",
            "last_name": "HAN",
            "credential": "LAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.