Mahmoud Khattab, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A97693 Issued in CA

Practice address

9390 Big Horn Blvd
145
Elk Grove, CA 95758-7980

Phone

(916) 691-6666

Fax

(916) 691-6668

NPI assigned

Jun 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1063617603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9390 BIG HORN BLVD",
            "address_2": "145",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587980",
            "telephone_number": "916-691-6666",
            "fax_number": "916-691-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9390 BIG HORN BLVD",
            "address_2": "145",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587980",
            "telephone_number": "916-691-6666",
            "fax_number": "916-691-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATTAB",
        "first_name": "MAHMOUD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "50188",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301092458",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A97693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammed F Khan, PHARM D
• Wajahat M. Khan, M.D.
• Nina Kaur Khangura, M.D.
• Anubha Khanna, M.D.
• Katherine Karen Khathavong
• Rosemary Wangui Kiama
• Kenton Earl Kiaser, D.D.S.
• Beyene Teclehaiman Kidane
• Kimberly Kidane
• Suzanne Pauline Kiesz, LCSW

• Internal Medicine Physician in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.