Individual provider Active NPI

Duke S Han, PHD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1669696753
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25372 Issued in CA
Practice address
1520 San Pablo St
1St Floor
Los Angeles, CA 90033-5310
Phone
(323) 442-5900
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 071007085 IL
Neurology Physician 2084N0400X 071007085 IL
Clinical Psychologist 103TC0700X PSY25372 CA Primary

Addresses

Primary practice location

1520 San Pablo St
1St Floor
Los Angeles, CA 90033-5310

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5900

Other identifiers 1

IdentifierTypeStateIssuer
PSY25372OtherCACA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address duke.han@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071007085ILMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Behavioral Sciences Clinical Neuropsychologist Past Accepting new patients
Loyola University Physician Foundation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: duke.han@direct.usc.edu

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1669696753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST",
            "address_2": "1ST FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335310",
            "telephone_number": "323-442-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "DUKE",
        "middle_name": "S",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071007085",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "071007085",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "PSY25372",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "duke.han@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St",
            "address_2": "1st Floor",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.