Individual
CHAMNANETH KHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, PHN
Contact information
Practice address
2525 GRAND AVE, LONG BEACH, CA 90815-1765
(562) 570-4247
(562) 570-4099
Mailing address
2525 GRAND AVE, LONG BEACH, CA 90815-1765
(562) 570-4247
(562) 570-4099
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95039171
CA
163WC1500X
Community Health Registered Nurse
Primary
548450
CA
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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