Individual provider Active NPI

Hong Veng Khoeur, PA-C

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1366514606
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16815 Issued in CA
Practice address
4881 E Belmont Ave
Fresno, CA 93727-2324
Phone
(559) 456-3955
Fax
(559) 456-9931
NPI assigned
Nov 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16815 CA Primary

Addresses

Primary practice location

4881 E Belmont Ave
Fresno, CA 93727-2324

Mailing address

4881 E Belmont Ave
Fresno, CA 93727-2324
Phone (559) 456-3955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060508000302 CA Practitioner - Physician Assistant 2062423908 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366514606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 E BELMONT AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937272324",
            "telephone_number": "559-456-3955",
            "fax_number": "559-456-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 E BELMONT AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937272324",
            "telephone_number": "559-456-3955",
            "fax_number": "559-456-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOEUR",
        "first_name": "HONG",
        "middle_name": "VENG",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.