Provider Demographics
NPI:1487822086
Name:ANDKHOY, KHATUL (LAC)
Entity Type:Individual
Prefix:MRS
First Name:KHATUL
Middle Name:
Last Name:ANDKHOY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 BALBOA BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-5403
Mailing Address - Country:US
Mailing Address - Phone:818-701-7070
Mailing Address - Fax:818-993-9900
Practice Address - Street 1:9900 BALBOA BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-5403
Practice Address - Country:US
Practice Address - Phone:818-701-7070
Practice Address - Fax:818-993-9900
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5168171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist