Jackson Kham

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

1105 N El Dorado St
Stockton, CA 95202-1305

Phone

(209) 938-0228

Fax

(209) 938-0281

NPI assigned

Aug 24, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1295348951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 N EL DORADO ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021305",
            "telephone_number": "209-938-0228",
            "fax_number": "209-938-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 N EL DORADO ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021305",
            "telephone_number": "209-938-0228",
            "fax_number": "209-938-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAM",
        "first_name": "JACKSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkham@medmark.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "N/A",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "1105 N El Dorado St",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952021305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sheril Keys
• Bernadette Khalil
• Mahmoud Khalil
• MD Ibrahim Khalil, DDS
• Saleem Khalili, PHARMD
• Aziz Khambati, M.D.
• Lubena Shakir Khambaty, M.D.
• Sophia Arcadia Khamjoi
• Jerri Khammanh
• Rhonda R Khamo

• Other Technician in Stockton, CA
• Providers in Stockton, CA by specialty
• Other Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.