Provider Demographics
NPI:1720010887
Name:KHIEV, SEN (DC)
Entity Type:Individual
Prefix:
First Name:SEN
Middle Name:
Last Name:KHIEV
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5152 KATELLA AVE
Mailing Address - Street 2:STE. 202
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2817
Mailing Address - Country:US
Mailing Address - Phone:562-279-3045
Mailing Address - Fax:
Practice Address - Street 1:5152 KATELLA AVE
Practice Address - Street 2:STE. 202
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2817
Practice Address - Country:US
Practice Address - Phone:562-279-3045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor