Provider Demographics
NPI:1881655199
Name:KHIN, NU (MD)
Entity Type:Individual
Prefix:DR
First Name:NU
Middle Name:
Last Name:KHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8161 JOHNSTON RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-6727
Mailing Address - Country:US
Mailing Address - Phone:626-872-8627
Mailing Address - Fax:626-281-6083
Practice Address - Street 1:1212 E MAIN ST
Practice Address - Street 2:SUITE #1
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4161
Practice Address - Country:US
Practice Address - Phone:626-281-7654
Practice Address - Fax:626-281-6083
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA063817207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110246819OtherRAILROAD MEDICARE INDIVID
CA00A638170Medicaid
CA10957419OtherCAQH
CA110246819OtherRAILROAD MEDICARE INDIVID
CA00A638170Medicaid