NPIMap

Organization Active NPI

Han Sam Corp

  • Infusion Therapy Clinic/Center
  • Grass Valley, CA
National Provider Identifier
1861050502
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
HAN SAM CORP
Practice address
300 Sierra College Dr Ste 250
Grass Valley, CA 95945-5083
Phone
(530) 777-0119
NPI assigned
May 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Authorized official

Name
Hany Samuel Benjamin
Title
Owner
Phone
(760) 340-3248

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

300 Sierra College Dr Ste 250
Grass Valley, CA 95945-5083

Mailing address

16782 Von Karman Ave Ste 12
Irvine, CA 92606-2417
Phone (949) 783-7012

Other names 1

  • RE Infusion Center Grass Valley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Han Sam Corp6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 Sierra College Dr
Ste 250
Grass Valley, CA 95945
Phone (530) 777-0011

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1861050502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 12",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "949-783-7012",
            "fax_number": "949-743-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SIERRA COLLEGE DR STE 250",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455083",
            "telephone_number": "530-777-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAN SAM CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "BENJAMIN",
        "authorized_official_first_name": "HANY",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-340-3248"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RE Infusion Center Grass Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.