MEDICARE: LILIANE L. KHENG M.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
1	207R00000X	Internal Medicine Physician	MD-10419	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000224378	OTHER	HI	HMSA BCBS HAWAII
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285639104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIANE L. KHENG M.D.

Provider Business Mailing Address
First Line	:	3-3295 KUHIO HWY
Second Line	:
City	:	LIHUE
State	:	HI
Zip	:	96766-1040
Country	:	US
Telephone Number	:	808-245-8874
Fax Number	:	808-246-9080

Provider Business Practice Location Address
First Line	:	3-3295 KUHIO HWY
Second Line	:
City	:	LIHUE
State	:	HI
Zip	:	96766-1040
Country	:	US
Telephone Number	:	808-245-8874
Fax Number	:	808-246-9080

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	02/10/2016

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