Provider Demographics
NPI:1659980233
Name:KHOU, BELINDA KIM
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:KIM
Last Name:KHOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 YOSEMITE AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3538
Mailing Address - Country:US
Mailing Address - Phone:805-813-4847
Mailing Address - Fax:
Practice Address - Street 1:501 WILLARD ST APT 215
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3285
Practice Address - Country:US
Practice Address - Phone:805-813-4847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program