NPIMap

Organization Active NPI

Khalida Pathan MD Dba KP Medical Center

Doing business as KP Medical Center

  • Primary Care Clinic/Center
  • Altadena, CA
National Provider Identifier
1205287208
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
KHALIDA PATHAN MD DBA KP MEDICAL CENTER
Doing business as
KP Medical Center
Practice address
888 Morada PL
Altadena, CA 91001-2425
Phone
(626) 696-3692
NPI assigned
Jun 30, 2016
Last updated
Apr 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Dr. Khalida A Pathan, MDNPI 1265627707
Title
Physician/Sole Proprietor
Phone
(626) 696-3692

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary
Pain Clinic/Center 261QP3300X NU
Preferred Provider Organization 305R00000X A97589 CA

Addresses

Primary practice location

888 Morada PL
Altadena, CA 91001-2425

Mailing address

888 Morada PL
Altadena, CA 91001-2425
Phone (626) 696-3692

Other names 1

  • KP Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1205287208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 MORADA PL",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910012425",
            "telephone_number": "626-696-3692",
            "fax_number": "626-696-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 MORADA PL",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910012425",
            "telephone_number": "626-696-3692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHALIDA PATHAN MD DBA KP MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "PATHAN",
        "authorized_official_first_name": "KHALIDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN/SOLE PROPRIETOR",
        "authorized_official_telephone_number": "626-696-3692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "A97589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KP Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Altadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.