Provider Demographics
NPI:1912883315
Name:HANMAUM MEDICAL CENTER
Entity type:Organization
Organization Name:HANMAUM MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAE-WON
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-260-9436
Mailing Address - Street 1:305 N HARBOR BLVD STE 317
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1901
Mailing Address - Country:US
Mailing Address - Phone:949-415-3335
Mailing Address - Fax:949-415-3336
Practice Address - Street 1:24361 EL TORO RD STE 105
Practice Address - Street 2:
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-2756
Practice Address - Country:US
Practice Address - Phone:949-415-3335
Practice Address - Fax:949-415-3336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty