Provider Demographics
NPI:1235418575
Name:KHIN KHIN OO, M.D., INC
Entity Type:Organization
Organization Name:KHIN KHIN OO, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KHIN
Authorized Official - Middle Name:KHIN
Authorized Official - Last Name:OO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-744-9290
Mailing Address - Street 1:238 S ARROYO PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-4190
Mailing Address - Country:US
Mailing Address - Phone:626-744-9290
Mailing Address - Fax:626-744-9276
Practice Address - Street 1:238 S ARROYO PKWY STE 150
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-4190
Practice Address - Country:US
Practice Address - Phone:626-744-9290
Practice Address - Fax:626-744-9276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-04
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56521207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG73966Medicare UPIN