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NPI Code Detail

MEDICARE: KONTERRI KHUN

MEDICARE:   KONTERRI  KHUN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1538645668
Entity Type Code : Individual
Provider Name (Legal Business Name) : KONTERRI KHUN
Provider Business Mailing Address
First Line : 1624 SANTA CLARA DR
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3554
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1624 SANTA CLARA DR
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3554
Country : US
Telephone Number : 916-779-2455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2018
Last Update Date : 07/11/2018

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Directions to “ KONTERRI KHUN ” Practice Location

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