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Shelley H Han

Internal Medicine

Allopathic & Osteopathic Physicians

4733 W Sunset Blvd, 3rd Floor, Los Angeles, CA 90027-6021

PECOS Enrollment

This provider is enrolled in PECOS as SHELLEY HAN.

Based on the most recent information from CMS, provider Shelley H Han is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1114345683
Provider Type
Individual
Full Name
Han, Shelley H
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
4/2/2014
Last Updated
3/19/2016

Contact Information

Practice Location

4733 W Sunset Blvd, 3rd Floor, Los Angeles, CA 90027-6021

(323) 783-0339

Unlisted Fax

Mailing Location

4733 W Sunset Blvd, 3rd Floor, Los Angeles, CA 90027-6021

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License A139242 California

Shelley H Han

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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