Khatira Mohmmad Gheran, NP

Key facts

NPI

1124861778

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

95030475 (CA)

Practice address

7300 Medical Center Dr
West Hills, CA 91307-1902

Phone

(818) 676-4164

NPI assigned

Jun 13, 2024

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AGDJAA/Endpoint/AGDJAA

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 13, 2024.

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1124861778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 MEDICAL CTR",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071902",
            "telephone_number": "818-676-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 MEDICAL CENTER DR",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071902",
            "telephone_number": "818-676-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHERAN",
        "first_name": "KHATIRA",
        "middle_name": "MOHMMAD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95030475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in West Hills, CA · Family Medicine Physician in California