Provider Demographics
NPI:1831571496
Name:HUYNH, KHA
Entity type:Individual
Prefix:
First Name:KHA
Middle Name:
Last Name:HUYNH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10457 SCHMIDT RD
Mailing Address - Street 2:
Mailing Address - City:S EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-2161
Mailing Address - Country:US
Mailing Address - Phone:626-228-5238
Mailing Address - Fax:
Practice Address - Street 1:10457 SCHMIDT RD
Practice Address - Street 2:
Practice Address - City:S EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-2161
Practice Address - Country:US
Practice Address - Phone:626-228-5238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10501225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist