Individual provider Active NPI

Khalid B Khan, M.D.

  • Family Medicine Physician
  • Hawthorne, CA
National Provider Identifier
1063440840
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A62486 Issued in CA
Practice address
13425 Inglewood Ave
Hawthorne, CA 90250-5608
Phone
(310) 679-2201
Fax
(310) 679-4236
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A62486 CA Primary
Internal Medicine Physician 207R00000X A62486 CA
Pediatrics Physician 208000000X A62486 CA

Addresses

Primary practice location

13425 Inglewood Ave
Hawthorne, CA 90250-5608

Mailing address

13425 Inglewood Ave
Hawthorne, CA 90250-5608
Phone (310) 679-2201

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
I20050615000974 CA Practitioner - Internal MedicinePractitioner - Family Practice 1254375777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13425 Inglewood Ave
Hawthorne, CA 90250-5608
Phone (310) 679-2201

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Khalid B. Khan M.D., Inc Family Medicine CurrentSince Dec 15, 1999 Accepting new patients
Emergency Department Physicians Medical Group, Inc. Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Deanco Healthcare LLC. Past Accepting new patients
Jse Emergency Medical Group Past Accepting new patients

Locations

13425 Inglewood Ave
Hawthorne, CA 90250
Phone (310) 679-2201

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: khalid.khan.p167@direct.healthcarepartners.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1063440840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13425 INGLEWOOD AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505608",
            "telephone_number": "310-679-2201",
            "fax_number": "310-679-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13425 INGLEWOOD AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505608",
            "telephone_number": "310-679-2201",
            "fax_number": "310-679-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KHALID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A62486",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A62486",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A62486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.