Provider Demographics
NPI:1558425595
Name:KHOURY, CHRISTINE SAMI (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:SAMI
Last Name:KHOURY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 POST ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3473
Mailing Address - Country:US
Mailing Address - Phone:415-292-0638
Mailing Address - Fax:
Practice Address - Street 1:2299 POST ST
Practice Address - Street 2:205
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3441
Practice Address - Country:US
Practice Address - Phone:415-292-0638
Practice Address - Fax:415-292-0718
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4243213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E42430Medicaid
CA000E42430Medicare PIN
CAU78436Medicare UPIN
CA1310050001Medicare NSC