MEDICARE: DR. CHARLIE KHONG D.C.

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
1	111N00000X	Chiropractor	DC	CA

General Provider Information

NPI Number	:	1255958765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLIE KHONG D.C.

Provider Business Mailing Address
First Line	:	1650 XIMENO AVE STE 210A
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-2150
Country	:	US
Telephone Number	:	562-231-6250
Fax Number	:	562-502-3516

Provider Business Practice Location Address
First Line	:	1650 XIMENO AVE STE 210A
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-2150
Country	:	US
Telephone Number	:	562-231-6250
Fax Number	:	562-502-3516

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2020
Last Update Date	:	06/04/2026

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Directions to “ DR. CHARLIE KHONG D.C.” Practice Location

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