Individual
EDWARD JIN HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 WILLOW CREEK RD STE 2200, PRESCOTT, AZ 86301-1614
(928) 445-6025
(928) 778-3026
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2004018553
MO
207RC0000X
Cardiovascular Disease Physician
37453
IA
207RC0000X
Cardiovascular Disease Physician
Primary
46688
AZ
207RI0011X
Interventional Cardiology Physician
2008014944
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3085174
—
OH
05
—
3810018717
—
WV
01
—
46688
46688
AZ
05
—
7100137840
—
KY
01
—
P00875685
MEDICARE RAILROAD
KY
Enumeration date
09/21/2006
Last updated
02/17/2025
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