Individual provider Active NPI

Sonal Khattri, MD

  • Pediatrics Physician
  • Poway, CA
National Provider Identifier
1013997303
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A105678 Issued in CA
Practice address
15611 Pomerado Rd
Suite 400
Poway, CA 92064-2437
Phone
(858) 675-3170
Fax
(858) 675-0518
NPI assigned
Jan 20, 2006
Last updated
Sep 8, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A105678 CA Primary

Addresses

Primary practice location

15611 Pomerado Rd
Suite 400
Poway, CA 92064-2437

Mailing address

PO Box 28199
San Diego, CA 92198-0199
Phone (858) 675-3100

Other identifiers 1

IdentifierTypeStateIssuer
A105678OtherCAMEDICAL LICENSE

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
I20151001003250 CA Practitioner - Pediatric Medicine 7517902612 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105678CAMDDentist
A105678CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Nov 7, 2016 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Pediatrics CurrentSince Nov 7, 2016 Accepting new patients
Arch Health Partners CurrentSince Oct 1, 2015 Accepting new patients
Arch Health Partners, Inc Pediatrics CurrentSince Oct 1, 2015 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Franciscan Health Crown Point Past Accepting new patients
Franciscan Health Crown Point Past Accepting new patients
Palomar Health Past Accepting new patients

Locations

15611 Pomerado Rd
Ste 400
Poway, CA 92064
Phone (858) 613-8900

10243 Genetic Center Dr
San Diego, CA 92121
Phone (858) 499-2704

16899 W Bernardo Dr
San Diego, CA 92127
Phone (858) 499-2705

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

Interoperability endpoints

  • Direct secure messaging: sonal.khattri.p1@direct.arch.nextgenshare.com

Organizations & group practices 8

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1013997303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28199",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921980199",
            "telephone_number": "858-675-3100",
            "fax_number": "858-618-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15611 POMERADO RD",
            "address_2": "SUITE 400",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642437",
            "telephone_number": "858-675-3170",
            "fax_number": "858-675-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATTRI",
        "first_name": "SONAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A105678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A105678",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.