Healthcare Provider Details

I. General information

NPI: 1972997302
Provider Name (Legal Business Name): CHRISTINE ELIZABETH KHO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 08/28/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5427 WHITTIER BLVD
LOS ANGELES CA
90022-4101
US

IV. Provider business mailing address

5427 WHITTIER BLVD
LOS ANGELES CA
90022-4101
US

V. Phone/Fax

Practice location:
  • Phone: 888-499-9303
  • Fax:
Mailing address:
  • Phone: 888-499-9303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA145683
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA145683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: