Individual provider Active NPI

Morris Kokhab, M.D.

  • Rheumatology Physician
  • Upland, CA
National Provider Identifier
1245248681
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
A75850 Issued in CA
Practice address
974 W Foothill Blvd
Upland, CA 91786-3728
Phone
(909) 932-1122
Fax
(909) 932-9292
NPI assigned
Aug 3, 2006
Last updated
Jul 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X A75850 CA Primary

Addresses

Primary practice location

974 W Foothill Blvd
Upland, CA 91786-3728

Mailing address

13037 San Vicente Blvd
Los Angeles, CA 90049-4814
Phone (310) 945-6070

Other identifiers 1

IdentifierTypeStateIssuer
00A758500MedicaidCA

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
I20040614001686 CA Practitioner - RheumatologyPractitioner - General PracticePractitioner - Internal Medicine 4385628767 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75850CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Urgent Care, Inc. CurrentSince May 24, 2014 Accepting new patients
Anaheim Urgent Care, Inc CurrentSince May 24, 2014 Accepting new patients
Anaheim Urgent Care, Inc. Rheumatology Current Accepting new patients
Sleep Disorders Center Past Accepting new patients

Locations

831 S State College Blvd
Anaheim, CA 92806
Phone (714) 533-2273

242 S Robertson Blvd
Beverly Hills, CA 90211
Phone (310) 652-2300

5717 Melrose Ave
Los Angeles, CA 90038
Phone (323) 957-2273

888 S Figueroa St
Ste 600
Los Angeles, CA 90017

524 Colorado Ave
Santa Monica, CA 90401
Phone (310) 260-2917

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1245248681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13037 SAN VICENTE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900494814",
            "telephone_number": "310-945-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863728",
            "telephone_number": "909-932-1122",
            "fax_number": "909-932-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKHAB",
        "first_name": "MORRIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A75850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A758500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.