Physician Compare National (NPI:1376863142)

HEALTHCARE PROVIDER: KATHY KHONG O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1376863142
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597945667
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110207000381
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KHONG
	Individual professional last name
Provider First Name	KATHY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1300 SW 6TH AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 150
	Group Practice or individual's line 2 address
City	PORTLAND
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	972013525
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y