Active NPI
Shoaib Khan
- Student in an Organized Health Care Education/Training Program
- Antelope, CA
National Provider Identifier
1194390534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- INT-44093
- Practice address
- 7901 Watt Ave
Antelope, CA 95843-2002 - Phone
- (209) 914-5851
- NPI assigned
- May 26, 2021
- Last updated
- Jul 4, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | INT-44093 | CA | Primary |
Addresses
Primary practice location
7901 Watt Ave
Antelope, CA 95843-2002
Mailing address
1575 W Pacheco Blvd
Los Banos, CA 93635-8505
Phone (209) 826-9653
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | shoaib465@yahoo.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| INT-44093 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
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": "1621987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656892800000",
"number": "1194390534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 W PACHECO BLVD",
"city": "LOS BANOS",
"state": "CA",
"postal_code": "936358505",
"telephone_number": "209-826-9653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 WATT AVE",
"city": "ANTELOPE",
"state": "CA",
"postal_code": "958432002",
"telephone_number": "209-914-5851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "SHOAIB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-26",
"last_updated": "2022-07-04",
"certification_date": "2022-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "INT-44093",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "shoaib465@yahoo.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "n/a",
"address_1": "7901 Watt Ave",
"city": "Antelope",
"state": "CA",
"country_code": "US",
"postal_code": "958432002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Antelope, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.