Individual provider Active NPI

Maribel P. Khoury, M.D.

  • Family Medicine Physician
  • Paramount, CA
National Provider Identifier
1184659609
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A88689 Issued in CA
Practice address
14906 Paramount Blvd
Paramount, CA 90723-3409
Phone
(562) 630-1991
Fax
(562) 630-0145
NPI assigned
Jul 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 A88689 CA Primary

Addresses

Primary practice location

14906 Paramount Blvd
Paramount, CA 90723-3409

Mailing address

14906 Paramount Blvd
Paramount, CA 90723-3409
Phone (562) 630-1991

Other identifiers 1

IdentifierTypeStateIssuer
00A886890MedicaidCA

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
I20070206000690 CA Practitioner - Family Practice 8224030168 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Group of Paramount, Inc. Family Medicine CurrentSince Aug 11, 2012 Accepting new patients
Altamed Health Services Corporation PastSince Aug 11, 2012 Accepting new patients

Locations

14906 Paramount Blvd
Paramount, CA 90723
Phone (323) 948-5418

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184659609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14906 PARAMOUNT BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907233409",
            "telephone_number": "562-630-1991",
            "fax_number": "562-630-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14906 PARAMOUNT BLVD",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907233409",
            "telephone_number": "562-630-1991",
            "fax_number": "562-630-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "MARIBEL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A88689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A886890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramount, CA

Sources for this page

Verify at the official NPI Registry.