Individual
HAI RYUN BACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 CENTRAL AVE APT 203, ALAMEDA, CA 94501-3746
(734) 934-6508
Mailing address
550 CENTRAL AVE APT 203, ALAMEDA, CA 94501-3746
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704402022
MI
163W00000X
Registered Nurse
861876
NY
163W00000X
Registered Nurse
Primary
95403840
CA
Other
Enumeration date
04/11/2025
Last updated
04/11/2025
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