Khae Saephanh, D.o., Inc | |
1569 Lexann Ave Suite 128 San Jose CA 95121-1793 | |
(408) 274-3200 | |
(408) 274-8021 |
Full Name | Khae Saephanh, D.o., Inc |
---|---|
Speciality | Family Medicine |
Location | 1569 Lexann Ave, San Jose, California |
Authorized Official Name and Position | Khae Vang Saephanh (DOCTOR) |
Authorized Official Contact | 4082743200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Khae Saephanh, D.o., Inc Po Box 32611 San Jose CA 95152-2611 Ph: (408) 274-3200 | Khae Saephanh, D.o., Inc 1569 Lexann Ave Suite 128 San Jose CA 95121-1793 Ph: (408) 274-3200 |
NPI Number | 1891858650 |
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Provider Enumeration Date | 12/19/2006 |
Last Update Date | 03/07/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891858650 | NPI | - | NPPES |
20A9049 | Other | CA | MEDICAL LICENCE |
00AX90490 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20A9049 (California) | Primary |
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