Provider Demographics
NPI:1447279948
Name:KHIN, KHINE (KAREN) K (MD)
Entity type:Individual
Prefix:DR
First Name:KHINE (KAREN)
Middle Name:K
Last Name:KHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:K
Other - Last Name:KHIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:500 S ANAHEIM HILLS RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4780
Mailing Address - Country:US
Mailing Address - Phone:714-974-2820
Mailing Address - Fax:714-974-1539
Practice Address - Street 1:500 S ANAHEIM HILLS RD
Practice Address - Street 2:SUITE 230
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-4780
Practice Address - Country:US
Practice Address - Phone:714-974-2820
Practice Address - Fax:714-974-1539
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67196207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A671960Medicaid
CABK6445705OtherDEA REGISTRATION NUMBER
CABK6445705OtherDEA REGISTRATION NUMBER