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NPI Code Detail

MEDICARE: PHENG KHANG

MEDICARE: PHENG KHANG
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
1225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1538018668
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHENG KHANG
Provider Business Mailing Address
First Line : 2549 W SHAW AVE
Second Line :
City : FRESNO
State : CA
Zip : 93711-3308
Country : US
Telephone Number : 559-264-7521
Fax Number : 559-860-0168
Provider Business Practice Location Address
First Line : 2549 W SHAW AVE
Second Line :
City : FRESNO
State : CA
Zip : 93711-3308
Country : US
Telephone Number : 559-264-7521
Fax Number : 559-860-0168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/26/2026

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Directions to “ PHENG KHANG ” Practice Location

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