Individual provider Active NPI

Kisoo Han, D.C.

  • Chiropractor
  • San Francisco, CA
National Provider Identifier
1740306745
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC29614 Issued in CA
Practice address
1545 Broadway
Ste 1a
San Francisco, CA 94109-2539
Phone
(415) 563-3800
Fax
(415) 292-7911
NPI assigned
Mar 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC29614 CA Primary

Addresses

Primary practice location

1545 Broadway
Ste 1a
San Francisco, CA 94109-2539

Mailing address

1545 Broadway
Ste 1a
San Francisco, CA 94109-2539
Phone (415) 563-3800

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

State licenses

LicenseStateTypeSpecialty
DC29614CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Azzolino Chiropractic Neurology & Integrative Wellness, Inc PastSince Apr 15, 2013 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740306745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 BROADWAY",
            "address_2": "STE 1A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941092539",
            "telephone_number": "415-563-3800",
            "fax_number": "415-292-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 BROADWAY",
            "address_2": "STE 1A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941092539",
            "telephone_number": "415-563-3800",
            "fax_number": "415-292-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "KISOO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.