Provider Demographics
NPI:1487615878
Name:KHAUV, MENG KONG (MD)
Entity type:Individual
Prefix:DR
First Name:MENG
Middle Name:KONG
Last Name:KHAUV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 W SANTA MARIA WAY
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-4400
Mailing Address - Country:US
Mailing Address - Phone:928-276-3870
Mailing Address - Fax:
Practice Address - Street 1:2555 E GILA RIDGE RD
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-2240
Practice Address - Country:US
Practice Address - Phone:800-470-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61335207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine