Individual provider Active NPI

Phuong Khuu, M.D.

  • Pediatric Dermatology Physician
  • Stanford, CA
National Provider Identifier
1528259744
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Dermatology PhysicianTaxonomy code 207NP0225X
License
A87498 Issued in CA
Practice address
900 Blake Wilbur Dr RM W0069
Stanford, CA 94305
Phone
(650) 723-9913
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dermatology Physician 207NP0225X A87498 CA Primary

Addresses

Primary practice location

900 Blake Wilbur Dr RM W0069
Stanford, CA 94305

Mailing address

991 Park Pacifica Ave
Pacifica, CA 94044-4414
Phone (650) 723-9913

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110315000178 CA Practitioner - Dermatology 1951583863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
87498CAMDPharmacist
A87498CAMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile CurrentSince Jan 1, 2011 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Stanford Health Care Past Accepting new patients

Locations

730 Welch Rd
Palo Alto, CA 94304
Phone (650) 723-4800

770 Welch Rd
Palo Alto, CA 94304
Phone (650) 498-4069

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

1195 W Fremont Ave
Sunnyvale, CA 94087
Phone (408) 426-5590

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1528259744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 PARK PACIFICA AVE",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940444414",
            "telephone_number": "650-723-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BLAKE WILBUR DR RM W0069",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "94305",
            "telephone_number": "650-723-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHUU",
        "first_name": "PHUONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "A87498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.