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NPI Code Detail

MEDICARE: KHANH NGAN PHAN HOANG PH.D.

MEDICARE: KHANH NGAN PHAN HOANG PH.D.
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
2103TB0200XCognitive & Behavioral PsychologistPSY25078CA

General Provider Information

NPI Number : 1184816654
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHANH NGAN PHAN HOANG PH.D.
Provider Business Mailing Address
First Line : 6330 VARIEL AVE STE 102
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-2543
Country : US
Telephone Number : 818-345-2345
Fax Number : 818-758-8015
Provider Business Practice Location Address
First Line : 19019 VENTURA BLVD
Second Line :
City : TARZANA
State : CA
Zip : 91356-3253
Country : US
Telephone Number : 818-345-2345
Fax Number : 818-758-8015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2007
Last Update Date : 10/03/2013

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