Individual provider Active NPI

Milly Perveen Khan, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1174625404
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C141332 Issued in CA
Practice address
1776 E Century Blvd
Los Angeles, CA 90002-3050
Phone
(323) 374-6848
Fax
(323) 889-7821
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C141332 CA Primary

Addresses

Primary practice location

1776 E Century Blvd
Los Angeles, CA 90002-3050

Mailing address

1776 E Century Blvd
Los Angeles, CA 90002-3050
Phone (323) 374-6848

Other identifiers 1

IdentifierTypeStateIssuer
01463301MedicaidPA

Other names 1

  • Dr. Milly Perveen Professional name

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
I20170323001314 CA Order and Referring Only - Family PracticePractitioner - Family Practice 8426962853

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C141332CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vish V.Iyer MD, PC Family Medicine PastSince Feb 1, 2002 Accepting new patients
Labriolas Integrative Health PC PastSince Feb 24, 2022 Accepting new patients
Community Family Health Centers Inc Past Accepting new patients
Pefha Health & Wellness Center Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mkhan1@direct.excelahealth.org
  • Direct secure messaging: mkhan10113@altamed.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1174625404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 E CENTURY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023050",
            "telephone_number": "323-374-6848",
            "fax_number": "323-889-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 E CENTURY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023050",
            "telephone_number": "323-374-6848",
            "fax_number": "323-889-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MILLY",
        "middle_name": "PERVEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C141332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01463301",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILLY",
            "last_name": "PERVEEN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.